State and Regional Variation in Prescription- and Payment-Related Promoters of Adherence to Blood Pressure Medication.
State and Regional Variation in Prescription- and Payment-Related Promoters of Adherence to Blood Pressure Medication.
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DOI：
10.5888/pcd17.190440
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发表时间：
2020-09-24
影响因子：
5.5
通讯作者：
Wozniak GD
中科院分区：
文献类型：
--
作者：
Yang PK;Ritchey MD;Tsipas S;Loustalot F;Wozniak GD
坚持服药可以改善高血压的管理。如何处方和购买降压药可以促进或阻碍依从性。我们使用了Symphony Health的2017年综合数据分析（Integrated Dataverse）中关于处方降压药的综合配药数据，以评估促进药物依从性的处方和支付相关因素（即固定剂量组合、通用配方、邮购、低成本或无共付药物）在美国各州和人口普查地区以及不同细分市场(按患者年龄、处方类型、和付款人类型)负责最大数量的血压药物填充。2017年，有7.065亿张降压药处方被开具，占总支出290亿美元（患者承担17.0%）。作为所有填充的比例，促进依从性的因素因州而异：固定剂量组合（从缅因州的5.8%到密西西比州的17.9%）；通用配方（从新泽西州的95.2%到明尼苏达州的98.4%）；邮购（从罗德岛的4.7%上升到特拉华州的14.5%）；较低或没有共同支付（从犹他州的56.6%到加利福尼亚州的72.8%）。此外，每次填充的平均天数（从阿肯色州的43.1天到缅因州的63.8天）和每个治疗年的患者支出（从夏威夷的38美元到乔治亚州的76美元）各不相同。依附性因素的集中度因市场细分而异。年龄在18至64岁之间、有初级保健医生处方和医疗补助覆盖的患者，固定剂量联合用药的浓度最低，每次用药的平均天数和每次治疗年的患者支出最低。65岁以上、有初级保健医生处方和商业保险的患者使用固定剂量组合制剂和邮购制剂的浓度最高。解决促进降压药依从性因素的区域和市场差异可能会增加依从性并改善高血压管理。
Medication adherence can improve hypertension management. How blood pressure medications are prescribed and purchased can promote or impede adherence. We used comprehensive dispensing data on prescription blood pressure medication from Symphony Health’s 2017 Integrated Dataverse to assess how prescription- and payment-related factors that promote medication adherence (ie, fixed-dose combinations, generic formulations, mail order, low-cost or no-copay medications) vary across US states and census regions and across the market segments (grouped by patient age, prescriber type, and payer type) responsible for the greatest number of blood pressure medication fills. In 2017, 706.5 million prescriptions for blood pressure medication were filled, accounting for $29.0 billion in total spending (17.0% incurred by patients). As a proportion of all fills, factors that promoted adherence varied by state: fixed-dose combinations (from 5.8% in Maine to 17.9% in Mississippi); generic formulations (from 95.2% in New Jersey to 98.4% in Minnesota); mail order (from 4.7% in Rhode Island to 14.5% in Delaware); and lower or no copayment (from 56.6% in Utah to 72.8% in California). Furthermore, mean days’ supply per fill (from 43.1 in Arkansas to 63.8 in Maine) and patient spending per therapy year (from $38 in Hawaii to $76 in Georgia) varied. Concentration of adherence factors differed by market segment. Patients aged 18 to 64 with a primary care physician prescriber and Medicaid coverage had the lowest concentration of fixed-dose combination fills, mean days’ supply per fill, and patient spending per therapy year. Patients aged 65 years or older with a primary care physician prescriber and commercial insurance had the highest concentration of fixed-dose combinations fills and mail order fills. Addressing regional and market segment variation in factors promoting blood pressure medication adherence may increase adherence and improve hypertension management.
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影响因子：
--
作者：
Reichert, S;Simon, T;Halm, EA
通讯作者：
Halm, EA
DOI：
10.1016/j.japh.2016.12.065
发表时间：
2017-03-01
影响因子：
2.1
作者：
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通讯作者：
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