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Articles 1 - 24 of 24
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Baseline And Follow-Up Laboratory Monitoring Of Cardiovascular Medications, Jennifer Tjia, Shira Fischer, Marsha Raebel, Daniel Peterson, Yanfang Zhao, Shawn Gagne, Jerry Gurwitz, Terry Field
Baseline And Follow-Up Laboratory Monitoring Of Cardiovascular Medications, Jennifer Tjia, Shira Fischer, Marsha Raebel, Daniel Peterson, Yanfang Zhao, Shawn Gagne, Jerry Gurwitz, Terry Field
Jennifer Tjia
BACKGROUND: Laboratory monitoring of medications is typically used to establish safety prior to drug initiation and to detect drug-related injury following initiation. It is unclear whether black box warnings (BBWs) as well as evidence- and consensus-based clinical guidelines increase the likelihood of appropriate monitoring. OBJECTIVE: To determine the proportion of patients newly initiated on selected cardiovascular medications with baseline assessment and follow-up laboratory monitoring and compare the prevalence of laboratory testing for drugs with and without BBWs and guidelines. METHODS: This cross-sectional study included patients aged 18 years or older from a large multispecialty group practice who were prescribed a …
Predicting Nursing Home Adherence To A Clinical Trial Intervention: Lessons For The Conduct Of Cluster Randomized Trials, Jennifer Tjia, Kathleen Mazor, Terry Field, Peter Doherty, Ann Spenard, Jerry Gurwitz
Predicting Nursing Home Adherence To A Clinical Trial Intervention: Lessons For The Conduct Of Cluster Randomized Trials, Jennifer Tjia, Kathleen Mazor, Terry Field, Peter Doherty, Ann Spenard, Jerry Gurwitz
Jennifer Tjia
OBJECTIVES: To describe factors predictive of nursing home (NH) adherence to a clinical trial intervention. DESIGN: Post hoc analysis of a cluster randomized trial (CRT) evaluating a structured communication intervention to improve nurse-physician telephone communication in NHs. SETTING: NH. PARTICIPANTS: All eligible licensed nursing staff in all participating NHs. MEASUREMENTS: Adherence was defined as active participation for at least 3 months of the 12-month trial. NH characteristics hypothesized to affect trial outcomes (profit status, bed size, nursing staff time, NH quality, and leadership turnover) were measured a priori. The association between intervention adherence, NH characteristics and preintervention questionnaire response rate …
Prescription Drug Benefits And Use Of Guideline Recommended Medications By Elderly Medicare Beneficiaries With Diabetes Mellitus, Jennifer Tjia, Becky Briesacher
Prescription Drug Benefits And Use Of Guideline Recommended Medications By Elderly Medicare Beneficiaries With Diabetes Mellitus, Jennifer Tjia, Becky Briesacher
Jennifer Tjia
OBJECTIVES: To determine whether prescription drug benefits are associated with the use of guideline recommended medications by older persons with type 2 diabetes mellitus (DM).
DESIGN: Cross-sectional study.
PARTICIPANTS: A national sample of Medicare beneficiaries with DM aged 65 and older and an indication for angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II-receptor blocker (ARB) use or high risk of coronary heart disease (hypertension or current smoking) who participated in the 2003 Medicare Current Beneficiary Survey.
MEASUREMENTS: Prescription drug coverage was measured according to self-report and verified according to insurance claims. Outcome variables were use of an ACEI or an ARB …
Diagnostic E-Codes For Commonly Used, Narrow Therapeutic Index Medications Poorly Predict Adverse Drug Events, Charles Leonard, Kevin Haynes, A. Localio, Sean Hennessy, Jennifer Tjia, Abigail Cohen, Stephen Kimmel, Harold Feldman, Joshua Metlay
Diagnostic E-Codes For Commonly Used, Narrow Therapeutic Index Medications Poorly Predict Adverse Drug Events, Charles Leonard, Kevin Haynes, A. Localio, Sean Hennessy, Jennifer Tjia, Abigail Cohen, Stephen Kimmel, Harold Feldman, Joshua Metlay
Jennifer Tjia
OBJECTIVE: We sought to examine the validity of specific hospital discharge codes in identifying drug toxicity precipitating hospitalization, among elderly users of high-risk medications. STUDY DESIGN AND SETTING: We conducted a cross-sectional evaluation assessing the diagnostic test characteristics of International Classification of Diseases-9 External-Cause-of-Injury codes (E-codes) compared with a reference standard of medical record review. This study was nested within a prospective cohort of elders using warfarin, digoxin, or phenytoin as identified in the Pharmaceutical Assistance Contract for the Elderly benefit program. RESULTS: We identified 4,803 subjects contributing 11,409 person-years of exposure to at least one of three drug groups. …
A Comparison Of Outcomes Resulting From Generalist Vs Specialist Care For A Single Discrete Medical Condition: A Systematic Review And Methodologic Critique, Gerald Smetana, Bruce Landon, Andrew Bindman, Helen Burstin, Roger Davis, Jennifer Tjia, Eugene Rich
A Comparison Of Outcomes Resulting From Generalist Vs Specialist Care For A Single Discrete Medical Condition: A Systematic Review And Methodologic Critique, Gerald Smetana, Bruce Landon, Andrew Bindman, Helen Burstin, Roger Davis, Jennifer Tjia, Eugene Rich
Jennifer Tjia
BACKGROUND: Studies of clinical outcomes for generalist vs specialist care for diagnoses within a specialist's narrow domain have tended to favor specialty care. METHODS: A MEDLINE search from January 1, 1980, through April 1, 2005, and a hand search of retrieved bibliographies of English-language studies that compared generalist vs specialist care for individual patients with a single discrete medical condition were performed. Two reviewers determined eligibility for each study and abstracted data onto a standardized instrument. RESULTS: A total of 49 articles met our inclusion criteria: 24 studies favored specialty care, 13 found no difference in outcomes, 7 varied by …
Unexplained Variation Across Us Nursing Homes In Antipsychotic Prescribing Rates., Yong Chen, Becky Briesacher, Terry Field, Jennifer Tjia, Denys Lau, Jerry Gurwitz
Unexplained Variation Across Us Nursing Homes In Antipsychotic Prescribing Rates., Yong Chen, Becky Briesacher, Terry Field, Jennifer Tjia, Denys Lau, Jerry Gurwitz
Jennifer Tjia
BACKGROUND: Serious safety concerns related to the use of antipsychotics have not decreased the prescribing of these agents to nursing home (NH) residents. We assessed the extent to which resident clinical characteristics and institutional prescribing practice were associated with antipsychotic prescribing.
METHODS: Antipsychotic prescribing was assessed for a nationwide, cross-sectional population of 16 586 newly admitted NH residents in 2006. We computed facility-level antipsychotic rates based on the previous year's (2005) prescribing patterns. Poisson regressions with generalized estimating equations were used to identify the likelihood of resident-level antipsychotic medication use in 2006, given 2005 facility-level prescribing pattern and NH resident …
A Systematic Review Of Validated Methods For Identifying Heart Failure Using Administrative Data, Jane Saczynski, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Katherine Dodd, Robert Goldberg, Jerry Gurwitz
A Systematic Review Of Validated Methods For Identifying Heart Failure Using Administrative Data, Jane Saczynski, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Katherine Dodd, Robert Goldberg, Jerry Gurwitz
Jennifer Tjia
PURPOSE: To identify and describe the validity of algorithms used to detect heart failure (HF) using administrative and claims data sources.
METHODS: A systematic review of PubMed and Iowa Drug Information Service searches of the English language was performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for the identification of patients with HF using and claims data. Abstracts and articles were reviewed by two study investigators to determine their relevance on the basis of predetermined criteria.
RESULTS: The initial search strategy identified 887 abstracts. Of these, 499 full articles were reviewed and 35 …
Growth In Dementia-Associated Hospitalizations Among The Oldest Old In The United States: Implications For Ethical Health Services Planning, Marya Zilberberg, Jennifer Tjia
Growth In Dementia-Associated Hospitalizations Among The Oldest Old In The United States: Implications For Ethical Health Services Planning, Marya Zilberberg, Jennifer Tjia
Jennifer Tjia
As the world population ages, an epidemic of neurologic diseases, such as Alzheimer-type dementia and Parkinson disease, is predicted. The most rapid population growth has been observed in the 85 years and older group ... Concurrent with this population growth, we have witnessed a vast expansion of health care utilization and expenditures, with the consequent close scrutiny and attempts to rein in this supply-driven juggernaut. ... We conducted this analysis to gain a better understanding of the current trends in dementia-associated hospitalizations among the 85 years and older population in the United States and its implications for future health care …
Medication Discrepancies Upon Hospital To Skilled Nursing Facility Transitions, Jennifer Tjia, Alice Bonner, Becky Briesacher, Sarah Mcgee, Eileen Terrill, Kathleen Miller
Medication Discrepancies Upon Hospital To Skilled Nursing Facility Transitions, Jennifer Tjia, Alice Bonner, Becky Briesacher, Sarah Mcgee, Eileen Terrill, Kathleen Miller
Jennifer Tjia
BACKGROUND: Failure to reconcile medications across transitions in care is an important source of harm to patients. Little is known about medication discrepancies upon admission to skilled nursing facilities (SNFs). OBJECTIVE: To describe the prevalence of, type of medications involved in, and sources of medication discrepancies upon admission to the SNF setting. DESIGN: Cross-sectional study. PARTICIPANTS: Patients admitted to SNF for subacute care. MEASUREMENTS: Number of medication discrepancies, defined as unexplained differences among documented medication regimens, including the hospital discharge summary, patient care referral form and SNF admission orders. RESULTS: Of 2,319 medications reviewed on admission, 495 (21.3%) had a …
Medicare Beneficiaries And Free Prescription Drug Samples: A National Survey., Jennifer Tjia, Becky Briesacher, Stephen Soumerai, Marsha Pierre-Jacques, Fang Zhang, Dennis Ross-Degnan, Jerry Gurwitz
Medicare Beneficiaries And Free Prescription Drug Samples: A National Survey., Jennifer Tjia, Becky Briesacher, Stephen Soumerai, Marsha Pierre-Jacques, Fang Zhang, Dennis Ross-Degnan, Jerry Gurwitz
Jennifer Tjia
BACKGROUND: New policies regulating physician/pharmaceutical company relationships propose to eliminate access to free prescription drug samples. Little is known about the prevalence of patient activity in requesting or receiving free prescription drug samples, or the characteristics of patients who access drug samples. OBJECTIVE: To determine the prevalence of free sample access and to examine demographic, clinical, and insurance characteristics of Medicare beneficiaries who access free samples. DESIGN: Cross-sectional study. PARTICIPANTS: A national sample of 13,847 Medicare beneficiaries participating in the fall 2004 Medicare Current Beneficiary Survey. MEASUREMENTS AND MAIN RESULTS: Prevalence of free prescription drug sample access (self-reported request for …
Challenge Of Changing Nursing Home Prescribing Culture, Jennifer Tjia, Jerry Gurwitz, Becky Briesacher
Challenge Of Changing Nursing Home Prescribing Culture, Jennifer Tjia, Jerry Gurwitz, Becky Briesacher
Jennifer Tjia
This article described a framework for improving prescribing in nursing homes (NH) by focusing on the whole facility as a system that has created a "prescribing culture." We offered this paradigm as an alternative to focused interventions that target prescribers only. We used the example of atypical antipsychotics to illustrate the approach. We also highlighted elements of the NH culture change movement that are germane to medication prescribing, and illustrated which elements of NH culture were shown to be associated with suboptimal quality of care. We concluded by describing current models, including our study funded by the Agency for Healthcare …
A Systematic Review Of Validated Methods For Identifying Cerebrovascular Accident Or Transient Ischemic Attack Using Administrative Data, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Jane Saczynski, Katherine Dodd, Robert Goldberg, Jerry Gurwitz
A Systematic Review Of Validated Methods For Identifying Cerebrovascular Accident Or Transient Ischemic Attack Using Administrative Data, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Jane Saczynski, Katherine Dodd, Robert Goldberg, Jerry Gurwitz
Jennifer Tjia
PURPOSE: To perform a systematic review of the validity of algorithms for identifying cerebrovascular accidents (CVAs) or transient ischemic attacks (TIAs) using administrative and claims data. METHODS: PubMed and Iowa Drug Information Service searches of the English language literature were performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for identifying CVAs (ischemic and hemorrhagic strokes, intracranial hemorrhage, and subarachnoid hemorrhage) and/or TIAs in administrative data. Two study investigators independently reviewed the abstracts and articles to determine relevant studies according to pre-specified criteria. RESULTS: A total of 35 articles met the criteria for evaluation. …
Impact Of Health Information Technology Interventions To Improve Medication Laboratory Monitoring For Ambulatory Patients: A Systematic Review., Shira Fischer, Jennifer Tjia, Terry Field
Impact Of Health Information Technology Interventions To Improve Medication Laboratory Monitoring For Ambulatory Patients: A Systematic Review., Shira Fischer, Jennifer Tjia, Terry Field
Jennifer Tjia
Medication errors are a major source of morbidity and mortality. Inadequate laboratory monitoring of high-risk medications after initial prescription is a medical error that contributes to preventable adverse drug events. Health information technology (HIT)-based clinical decision support may improve patient safety by improving the laboratory monitoring of high-risk medications, but the effectiveness of such interventions is unclear. Therefore, the authors conducted a systematic review to identify studies that evaluate the independent effect of HIT interventions on improving laboratory monitoring for high-risk medications in the ambulatory setting using a Medline search from January 1, 1980 through January 1, 2009 and a …
Quality Measurement Of Medication Monitoring In The "Meaningful Use" Era, Jennifer Tjia, Terry Field, Shira Fischer, Shawn Gagne, Daniel Peterson, Lawrence Garber, Jerry Gurwitz
Quality Measurement Of Medication Monitoring In The "Meaningful Use" Era, Jennifer Tjia, Terry Field, Shira Fischer, Shawn Gagne, Daniel Peterson, Lawrence Garber, Jerry Gurwitz
Jennifer Tjia
Objectives: While the 2011 implementation of "meaningful use" legislation for certified electronic health records (EHRs) promises to change quality reporting by overcoming data capture issues affecting quality measurement, the magnitude of this effect is unclear. We compared the measured quality of laboratory monitoring of Healthcare Effectiveness Data and Information Set (HEDIS) medications based on specifications that (1) include and exclude patients hospitalized in the measurement year and (2) use physician test orders and patient test completion. Study Design: Cross-sectional study. Methods: Among patients 18 years and older in a large multispecialty group practice utilizing a fully implemented EHR between January …
Daily Medication Use In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Margaret Rothman, Dan Kiely, Michele Shaffer, Holly Holmes, Greg Sachs, Susan Mitchell
Daily Medication Use In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Margaret Rothman, Dan Kiely, Michele Shaffer, Holly Holmes, Greg Sachs, Susan Mitchell
Jennifer Tjia
OBJECTIVES: To describe the pattern and factors associated with daily medication use in nursing home (NH) residents with advanced dementia. DESIGN: Prospective cohort study. SETTING: Twenty-two Boston-area NHs. PARTICIPANTS: NH residents with advanced dementia (N=323). MEASUREMENTS: Data from residents' records were used to determine the number or daily medications, specific drugs prescribed, and use of drugs deemed "never appropriate" in patients with advanced dementia. Resident characteristics associated with the use of more daily medications and drugs deemed inappropriate were examined. RESULTS: Residents were prescribed a mean of 5.9 +/- 3.0 daily medications, and 37.5% received at least one medication considered …
Deeply Discounted Medications: Implications Of Generic Prescription Drug Wars, Jessica Czechowski, Jennifer Tjia, Darren Triller
Deeply Discounted Medications: Implications Of Generic Prescription Drug Wars, Jessica Czechowski, Jennifer Tjia, Darren Triller
Jennifer Tjia
OBJECTIVE: To describe the history of generic prescription pricing programs at major pharmacy chains and their potential implications on prescribing, quality of care, and patient safety. DATA SOURCES: Publicly available generic prescription discount program drug lists as of May 1, 2009. SUMMARY: Fierce competition among major pharmacy chains such as Walgreens, CVS, and Walmart has led to a generic prescription pricing war with unclear public health implications. Introduced in 2006, currently 7 of the 10 largest pharmacy chains advertise a version of a deeply discounted medication (DDM) program, accounting for more than 25,000 locations nationally. By early 2008, almost 70 …
Racial And Ethnic Differences In Hospice Use Among Patients With Heart Failure, Jane Givens, Jennifer Tjia, Chao Zhou, Ezekiel Emanuel, Arlene Ash
Racial And Ethnic Differences In Hospice Use Among Patients With Heart Failure, Jane Givens, Jennifer Tjia, Chao Zhou, Ezekiel Emanuel, Arlene Ash
Jennifer Tjia
BACKGROUND: Heart failure is the leading noncancer diagnosis for patients in hospice care and the leading cause of hospitalization among Medicare beneficiaries. Racial and ethnic differences in hospice patients are well documented for patients with cancer but poorly described for those with heart failure.
METHODS: On the basis of a national sample of 98 258 Medicare beneficiaries 66 years and older on January 1, 2001, with a diagnosis of heart failure who had at least 1 physician or hospital encounter and who were not enrolled in hospice care between January 1 and December 31, 2000, we determined the effect of …
Randomized Trial Of A Warfarin Communication Protocol For Nursing Homes: An Sbar-Based Approach., Terry Field, Jennifer Tjia, Kathleen Mazor, Jennifer Donovan, Abir Kanaan, Leslie Harrold, George Reed, Peter Doherty, Ann Spenard, Jerry Gurwitz
Randomized Trial Of A Warfarin Communication Protocol For Nursing Homes: An Sbar-Based Approach., Terry Field, Jennifer Tjia, Kathleen Mazor, Jennifer Donovan, Abir Kanaan, Leslie Harrold, George Reed, Peter Doherty, Ann Spenard, Jerry Gurwitz
Jennifer Tjia
BACKGROUND: More than 1.6 million Americans currently reside in nursing homes. As many as 12% of them receive long-term anticoagulant therapy with warfarin. Prior research has demonstrated compelling evidence of safety problems with warfarin therapy in this setting, often associated with suboptimal communication between nursing home staff and prescribing physicians. METHODS: We conducted a randomized trial of a warfarin management protocol using facilitated telephone communication between nurses and physicians in 26 nursing homes in Connecticut in 2007-2008. Intervention facilities received a warfarin management communication protocol using the approach "Situation, Background, Assessment, and Recommendation" (SBAR). The protocol included an SBAR template …
Development And Pilot Testing Of Guidelines To Monitor High-Risk Medications In The Ambulatory Setting, Jennifer Tjia, Terry Field, Lawrence Garber, Jennifer Donovan, Abir Kanaan, Marsha Raebel, Yanfang Zhao, Jackie Fuller, Shawn Gagne, Shira Fischer, Jerry Gurwitz
Development And Pilot Testing Of Guidelines To Monitor High-Risk Medications In The Ambulatory Setting, Jennifer Tjia, Terry Field, Lawrence Garber, Jennifer Donovan, Abir Kanaan, Marsha Raebel, Yanfang Zhao, Jackie Fuller, Shawn Gagne, Shira Fischer, Jerry Gurwitz
Jennifer Tjia
OBJECTIVES: To develop guidelines to monitor high-risk medications and to assess the prevalence of laboratory testing for these medications among a multispecialty group practice. STUDY DESIGN: Safety intervention trial. METHODS: We developed guidelines for the laboratory monitoring of high-risk medications as part of a patient safety intervention trial. An advisory committee of national experts and local leaders used a 2-round Internet-based Delphi process to select guideline medications based on the importance of monitoring for efficacy, safety, and drug-drug interactions. Test frequency recommendations were developed by academic pharmacists based on a literature review and local interdisciplinary consensus. To estimate the potential …
Cholinesterase Inhibitor And Memantine Use In Newly Admitted Nursing Home Residents With Dementia, Carole Parsons, Becky Briesacher, Jane Givens, Yong Chen, Jennifer Tjia
Cholinesterase Inhibitor And Memantine Use In Newly Admitted Nursing Home Residents With Dementia, Carole Parsons, Becky Briesacher, Jane Givens, Yong Chen, Jennifer Tjia
Jennifer Tjia
OBJECTIVES: To quantify the use of cholinesterase inhibitors (ChEIs) and memantine in nursing home (NH) residents with dementia upon NH admission and 3 months later and to examine factors associated with reduction in therapy.
DESIGN: Retrospective cohort study.
SETTING: Nationwide sample of U.S. NHs.
PARTICIPANTS: Three thousand five hundred six NH residents with dementia newly admitted in 2006.
MEASUREMENTS: Data from pharmacy dispensing records were used to determine ChEI and memantine medication use upon NH admission and at 3-month follow-up. The Minimum Data Set was used to determine resident- and facility-level characteristics. Severity of dementia was defined using the Cognitive …
Interest In Breast Cancer Chemoprevention Among Older Women, Jennifer Tjia, Ellyn Micco, Katrina Armstrong
Interest In Breast Cancer Chemoprevention Among Older Women, Jennifer Tjia, Ellyn Micco, Katrina Armstrong
Jennifer Tjia
OBJECTIVES: The study aim is to describe interest in breast cancer chemoprevention among older women without a history of breast cancer and to determine whether aging-related factors such as diminished life expectancy, increasing comorbidity and medication burden attenuate chemoprevention interest. DESIGN: Cross-sectional survey. SETTING: University of Pennsylvania Health System. PARTICIPANTS: Four-hundred fifty-seven community-dwelling women aged 60-65 years old who were potentially eligible for breast cancer chemoprevention according to guidelines linking risk and eligibility to age. MEASUREMENTS: Interest in breast cancer chemopre vention, Gail model breast cancer risk, perceived breast cancer risk, breast cancer worry, self-reported health status and comorbidities, and …
Disparities In Combination Drug Therapy Use In Older Adults With Coronary Heart Disease: A Cross-Sectional Time-Series In A Nationally Representative Us Sample, Jennifer Tjia, Becky Briesacher, Dawei Xie, Jason Fu, Robert Goldberg
Disparities In Combination Drug Therapy Use In Older Adults With Coronary Heart Disease: A Cross-Sectional Time-Series In A Nationally Representative Us Sample, Jennifer Tjia, Becky Briesacher, Dawei Xie, Jason Fu, Robert Goldberg
Jennifer Tjia
BACKGROUND: Despite evidence of effective combination drug therapy for secondary prevention of coronary heart disease (CHD), older adults with this condition remain undertreated.
OBJECTIVE: To describe time trends (1992-2003) in the adoption of combination cardiac drug therapies (beta-blockers [beta-adrenoceptor antagonists], ACE inhibitors or angiotensin II type 1 receptor antagonists [angiotensin receptor blockers; ARBs], and lipid-lowering agents) among older adults in the US with CHD and to identify factors associated with not using combination therapy.
METHODS: The study took the form of a cross-sectional time-series. The study population consisted of a nationally representative sample of adults aged >or=65 years with CHD …
Beneath The Surface: Discovering The Unvoiced Concerns Of Older Adults With Type 2 Diabetes Mellitus, Jennifer Tjia, Jane Givens, Jason Karlawish, A. Okoli-Umeweni, Frances Barg
Beneath The Surface: Discovering The Unvoiced Concerns Of Older Adults With Type 2 Diabetes Mellitus, Jennifer Tjia, Jane Givens, Jason Karlawish, A. Okoli-Umeweni, Frances Barg
Jennifer Tjia
Emerging clinical guidelines recommend shared decision making to individualize drug regimens for older adults with Type 2 diabetes mellitus. While the current health education campaign for diabetes in the United States recommends physician-initiated medication-related discussions about adherence and side effects, little emphasis is placed on soliciting patient concerns. This study's aim was to explore the concerns of older adults with diabetes about the complexity of their drug regimens and to determine whether they discussed medication-related concerns with their physician. Twenty-two patients with Type 2 diabetes age 65 years and older who used five or more medications were selected from an …
Medicare Part D And Changes In Prescription Drug Use And Cost Burden: National Estimates For The Medicare Population, 2000 To 2007, Becky Briesacher, Yanfang Zhao, Jeanne Madden, Fang Zhang, Alyce Adams, Jennifer Tjia, Dennis Ross-Degnan, Jerry Gurwitz, Stephen Soumerai
Medicare Part D And Changes In Prescription Drug Use And Cost Burden: National Estimates For The Medicare Population, 2000 To 2007, Becky Briesacher, Yanfang Zhao, Jeanne Madden, Fang Zhang, Alyce Adams, Jennifer Tjia, Dennis Ross-Degnan, Jerry Gurwitz, Stephen Soumerai
Jennifer Tjia
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear.
OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D.
DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for earlier trends. Our analyses used the community-dwelling sample of the Medicare Current Beneficiary Survey (unweighted unique n=38,798). Actual post-Part D outcomes were compared with projected values using 2000 to 2005 data. Subgroup analyses and …