PMID- 34006485
OWN - NLM
STAT- MEDLINE
DCOM- 20220328
LR  - 20220401
IS  - 1934-8150 (Electronic)
IS  - 1551-7411 (Linking)
VI  - 18
IP  - 4
DP  - 2022 Apr
TI  - Association of low-income subsidy, medicaid dual eligibility, and disability 
      status with high-risk medication use among Medicare Part D beneficiaries.
PG  - 2634-2642
LID - S1551-7411(21)00171-6 [pii]
LID - 10.1016/j.sapharm.2021.05.005 [doi]
AB  - BACKGROUND: Low-income subsidy/dual eligibility (LIS/DE) status and disability 
      status may be associated with high-risk medication (HRM) use but are not usually 
      accounted for in medication-use quality measures. OBJECTIVE: To examine the 
      association of: 1) LIS/DE status and HRM use; and 2) disability status and HRM 
      use, while controlling for both health plan level effects and patient 
      characteristics for Medicare beneficiaries enrolled in Medicare Advantage 
      Prescription Drug Plans (MA-PD) and stand-alone Prescription Drug Plans (PDP). 
      METHODS: This retrospective cross-sectional study used 2013 Medicare data to 
      determine if LIS/DE status and disability status were independently associated 
      with HRM use (using the Pharmacy Quality Alliance HRM measure) in MA-PDs and 
      PDPs. Multivariable generalized linear mixed models assessed the association of 
      LIS/DE and HRM use, and disability and HRM use, after adjusting for health plan 
      effect and patient-level confounders for MA-PD and PDP beneficiaries. RESULTS: Of 
      520,019 MA-PD beneficiaries, 88,693 (17.1%) were LIS/DE and 48,997 (9.4%) were 
      disabled. Of 881,264 PDP beneficiaries, 213,096 (24.2%) were LIS/DE, and 83,593 
      (9.5%) were disabled. LIS/DE beneficiaries had a higher percent of HRM users 
      compared to non-LIS/DE MA-PD (13.3% vs. 9.7%, p < 0.001) and PDP (17.1% vs. 
      13.2%, p < 0.001) beneficiaries. Disabled beneficiaries had a higher percent of 
      HRM users compared to non-disabled MA-PD (17.0% vs. 9.6%, p < 0.001) and PDP 
      (22.9% vs. 13.2%, p < 0.001) beneficiaries. Multivariable analyses showed LIS/DE 
      (adjusted odds ratio [AOR] = 1.07; 95% CI = 1.04, 1.10) and disability 
      (AOR = 1.38; 95% CI = 1.34, 1.42) were associated with HRM use among MA-PD and 
      PDP beneficiaries (LIS/DE AOR = 1.14; 95% CI = 1.12, 1.16; disability AOR = 1.37; 
      95% CI = 1.34, 1.40). CONCLUSIONS: The association of LIS/DE and disability with 
      higher HRM use in both MA-PD and PDP beneficiaries, when controlling for health 
      plan effects and patient characteristics, suggests these factors should be 
      considered when comparing health plan performance on HRM measures.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Chinthammit, Chanadda
AU  - Chinthammit C
AD  - Department of Pharmaceutical Sciences, College of Pharmacy, University of 
      Arizona, Tucson, AZ, USA; Eli Lilly & Company, Indianapolis, IN, USA.
FAU - Bhattacharjee, Sandipan
AU  - Bhattacharjee S
AD  - Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, 
      USA.
FAU - Lo-Ciganic, Wei-Hsuan
AU  - Lo-Ciganic WH
AD  - Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University 
      of Florida, Gainesville, FL, USA.
FAU - Axon, David R
AU  - Axon DR
AD  - Department of Pharmacy Practice and Science, College of Pharmacy, University of 
      Arizona, Tucson, AZ, USA. Electronic address: axon@pharmacy.arizona.edu.
FAU - Slack, Marion
AU  - Slack M
AD  - Department of Pharmacy Practice and Science, College of Pharmacy, University of 
      Arizona, Tucson, AZ, USA.
FAU - Bentley, John P
AU  - Bentley JP
AD  - Department of Pharmacy Administration, School of Pharmacy, University of 
      Mississippi, University, MS, USA.
FAU - Warholak, Terri L
AU  - Warholak TL
AD  - Department of Pharmacy Practice and Science, College of Pharmacy, University of 
      Arizona, Tucson, AZ, USA.
LA  - eng
PT  - Journal Article
DEP - 20210511
PL  - United States
TA  - Res Social Adm Pharm
JT  - Research in social & administrative pharmacy : RSAP
JID - 101231974
SB  - IM
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Humans
MH  - Medicaid
MH  - *Medicare Part C
MH  - *Medicare Part D
MH  - Retrospective Studies
MH  - United States
OTO - NOTNLM
OT  - Disability
OT  - High-risk medication
OT  - Low-income subsidy
OT  - Medicaid dual eligibility
OT  - Medicare
OT  - Quality measures
EDAT- 2021/05/20 06:00
MHDA- 2022/03/29 06:00
CRDT- 2021/05/19 05:49
PHST- 2021/01/29 00:00 [received]
PHST- 2021/04/30 00:00 [revised]
PHST- 2021/05/03 00:00 [accepted]
PHST- 2021/05/20 06:00 [pubmed]
PHST- 2022/03/29 06:00 [medline]
PHST- 2021/05/19 05:49 [entrez]
AID - S1551-7411(21)00171-6 [pii]
AID - 10.1016/j.sapharm.2021.05.005 [doi]
PST - ppublish
SO  - Res Social Adm Pharm. 2022 Apr;18(4):2634-2642. doi: 
      10.1016/j.sapharm.2021.05.005. Epub 2021 May 11.