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Medication oversupply in patients with diabetes.

Publication ,  Journal Article
Thorpe, CT; Johnson, H; Dopp, AL; Thorpe, JM; Ronk, K; Everett, CM; Palta, M; Mott, DA; Chewning, B; Schleiden, L; Smith, MA
Published in: Research in social & administrative pharmacy : RSAP
May 2015

Studies in integrated health systems suggest that patients often accumulate oversupplies of prescribed medications, which is associated with higher costs and hospitalization risk. However, predictors of oversupply are poorly understood, with no studies in Medicare Part D.The aim of this study was to describe prevalence and predictors of oversupply of antidiabetic, antihypertensive, and antihyperlipidemic medications in adults with diabetes managed by a large, multidisciplinary, academic physician group and enrolled in Medicare Part D or a local private health plan.This was a retrospective cohort study. Electronic health record data were linked to medical and pharmacy claims and enrollment data from Medicare and a local private payer for 2006-2008 to construct a patient-quarter dataset for patients managed by the physician group. Patients' quarterly refill adherence was calculated using ReComp, a continuous, multiple-interval measure of medication acquisition (CMA), and categorized as <0.80 = Undersupply, 0.80-1.20 = Appropriate Supply, >1.20 = Oversupply. We examined associations of baseline and time-varying predisposing, enabling, and medical need factors to quarterly supply using multinomial logistic regression.The sample included 2519 adults with diabetes. Relative to patients with private insurance, higher odds of oversupply were observed in patients aged <65 in Medicare (OR = 3.36, 95% CI = 1.61-6.99), patients 65+ in Medicare (OR = 2.51, 95% CI = 1.37-4.60), patients <65 in Medicare/Medicaid (OR = 4.55, 95% CI = 2.33-8.92), and patients 65+ in Medicare/Medicaid (OR = 5.73, 95% CI = 2.89-11.33). Other factors associated with higher odds of oversupply included any 90-day refills during the quarter, psychotic disorder diagnosis, and moderate versus tight glycemic control.Oversupply was less prevalent than in previous studies of integrated systems, but Medicare Part D enrollees had greater odds of oversupply than privately insured individuals. Future research should examine utilization management practices of Part D versus private health plans that may affect oversupply.

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Published In

Research in social & administrative pharmacy : RSAP

DOI

EISSN

1934-8150

ISSN

1551-7411

Publication Date

May 2015

Volume

11

Issue

3

Start / End Page

382 / 400

Related Subject Headings

  • Wisconsin
  • United States
  • Sex Factors
  • Retrospective Studies
  • Prescription Drugs
  • Pharmacology & Pharmacy
  • Middle Aged
  • Medication Adherence
  • Medicare Part D
  • Male
 

Citation

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Thorpe, C. T., Johnson, H., Dopp, A. L., Thorpe, J. M., Ronk, K., Everett, C. M., … Smith, M. A. (2015). Medication oversupply in patients with diabetes. Research in Social & Administrative Pharmacy : RSAP, 11(3), 382–400. https://doi.org/10.1016/j.sapharm.2014.09.002
Thorpe, Carolyn T., Heather Johnson, Anna Legreid Dopp, Joshua M. Thorpe, Katie Ronk, Christine M. Everett, Mari Palta, et al. “Medication oversupply in patients with diabetes.Research in Social & Administrative Pharmacy : RSAP 11, no. 3 (May 2015): 382–400. https://doi.org/10.1016/j.sapharm.2014.09.002.
Thorpe CT, Johnson H, Dopp AL, Thorpe JM, Ronk K, Everett CM, et al. Medication oversupply in patients with diabetes. Research in social & administrative pharmacy : RSAP. 2015 May;11(3):382–400.
Thorpe, Carolyn T., et al. “Medication oversupply in patients with diabetes.Research in Social & Administrative Pharmacy : RSAP, vol. 11, no. 3, May 2015, pp. 382–400. Epmc, doi:10.1016/j.sapharm.2014.09.002.
Thorpe CT, Johnson H, Dopp AL, Thorpe JM, Ronk K, Everett CM, Palta M, Mott DA, Chewning B, Schleiden L, Smith MA. Medication oversupply in patients with diabetes. Research in social & administrative pharmacy : RSAP. 2015 May;11(3):382–400.
Journal cover image

Published In

Research in social & administrative pharmacy : RSAP

DOI

EISSN

1934-8150

ISSN

1551-7411

Publication Date

May 2015

Volume

11

Issue

3

Start / End Page

382 / 400

Related Subject Headings

  • Wisconsin
  • United States
  • Sex Factors
  • Retrospective Studies
  • Prescription Drugs
  • Pharmacology & Pharmacy
  • Middle Aged
  • Medication Adherence
  • Medicare Part D
  • Male