UNASSIGNED:大量研究记录了美国少数民族和白人在满足MedicareD部分药物治疗管理(MTM)计划的资格标准方面的不平等。尽管医疗保险和医疗补助服务中心试图放宽资格标准,有效的MTM改革的一个关键障碍是缺乏关于MTM对少数群体健康结果影响的更强有力的证据。
未经评估:为了检查综合药物审查(CMR)的效果,MTM核心组件,关于坚持糖尿病的种族和族裔差异,高血压,年龄≥65岁的医疗保险受益人中的高脂血症药物。
未经评估:这项研究使用了2017年全年MedicareA部分,B,和D索赔数据,包括MTM数据,链接到区域运行状况资源文件。不坚持糖尿病的种族和种族差异,高血压,比较了CMR受者和非受者之间的高脂血症药物,并根据他们的倾向评分进行匹配.为了确定收到CMR后种族和民族差异的变化,应用了差异框架,通过在逻辑回归分析中包括CMR接收的虚拟变量与每个种族或少数民族群体之间的交互项。
UNASSIGNED:与CMR非收件人相比,CMR接受者在三个结果指标中的种族和族裔差异显着降低,除了白人和黑人在不遵守糖尿病药物方面的差异。例如,与CMR非接受者相比,在CMR受者中,不坚持使用高血压药物的几率差异降低,分别,8%(95%置信区间[CI],白人和黑人之间的0.88-0.96);白人和西班牙裔之间的比例为18%(95%CI,0.78-0.86);白人和亚洲人之间的比例为16%(95%CI,0.77-0.91);白人与其他种族和族裔之间的比例为9%(95%CI,0.85-0.98)。
未经评估:接受CMR可以减少糖尿病患者的种族和民族差异,高血压,年龄≥65岁的医疗保险受益人中的高脂血症药物。这些发现提供了重要的经验证据,可以为MedicareD部分MTM计划的未来设计提供信息,这对于改善药物治疗结果是有价值的,并且当更多来自种族和少数民族的人被纳入时,可以进一步实现其潜力.
UNASSIGNED: Substantial research has documented inequalities between US minorities and whites in meeting the eligibility criteria for the Medicare Part D medication therapy management (MTM) program. Even though the Centers for Medicare & Medicaid Services attempted to relax the eligibility criteria, a critical barrier to effective MTM reform is a lack of stronger evidence about the effects of MTM on minorities\' health outcomes.
UNASSIGNED: To examine the effects of comprehensive medication review (CMR), an MTM core component, on racial and ethnic disparities in adherence to diabetes, hypertension, and hyperlipidemia medications among Medicare beneficiaries aged ≥65 years.
UNASSIGNED: This study used full-year 2017 Medicare Parts A, B, and D claims data, including MTM data, linked to the Area Health Resources Files. Racial and ethnic disparities in nonadherence to diabetes, hypertension, and hyperlipidemia medications were compared between CMR recipients and nonrecipients matched by their propensity scores. To determine the changes in racial and ethnic disparities after receiving CMR, a difference-in-differences framework was applied, by including in logistic regression analyses interaction terms between dummy variables for CMR receipt and each racial or ethnic minority group.
UNASSIGNED: Compared with CMR nonrecipients, CMR recipients had significantly lower racial and ethnic disparities across the 3 outcome measures, with the exception of the difference between whites and blacks in nonadherence to diabetes medications. For example, compared with CMR nonrecipients, among CMR recipients the differences in the odds of nonadherence to hypertension medications were reduced, respectively, by 8% (95% confidence interval [CI], 0.88-0.96) between whites and blacks; by 18% (95% CI, 0.78-0.86) between whites and Hispanics; by 16% (95% CI, 0.77-0.91) between whites and Asians; and by 9% (95% CI, 0.85-0.98) between whites and other racial and ethnic groups.
UNASSIGNED: Receiving a CMR reduced the racial and ethnic disparities in adherence to diabetes, hypertension, and hyperlipidemia medications among Medicare beneficiaries aged ≥65 years. These findings provide critical empirical evidence that may inform the future design of the Medicare Part D MTM program, which is valuable for improving pharmacotherapy outcomes and could further realize its potential when additional people from racial and ethnic minorities are enrolled.