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Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction.

Publication ,  Journal Article
Goyal, A; de Lemos, JA; Peng, SA; Thomas, L; Amsterdam, EA; Hockenberry, JM; Peterson, ED; Wang, TY
Published in: Circ Cardiovasc Qual Outcomes
November 2015

BACKGROUND: Little is known about whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). METHODS AND RESULTS: Using Medicare records linked to Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines, we identified 59 149 Medicare beneficiaries (age ≥65 years) discharged after AMI between January 2007 and December 2010. We described trends in Medicare Part D enrollment, and compared the following 30-day and 1-year outcomes: all-cause death, all-cause readmissions, and major adverse cardiac events (a composite of all-cause death or readmission for AMI or stroke) between Part D enrollees and nonenrollees, after adjustment for patient and hospital factors. From 2007 to 2010, 29 264 (49.5%) patients with AMI enrolled in Medicare were also participating in Part D by hospital discharge. All-cause 30-day death was more common among enrollees versus nonenrollees (4.0% versus 3.3%), but this difference was not statistically significant after multivariable adjustment (adjusted hazard ratio, 1.06 [95% confidence interval, 0.97-1.17]). Enrollees also had higher unadjusted risks of 30-day all-cause readmissions or major adverse cardiac events, and 1-year mortality, all-cause readmissions, or major adverse cardiac events, but these were attenuated after multivariable adjustment. Adherence to key secondary prevention medications (statins, β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and P2Y12 antagonists) remained low (range, 55%-64%) at 1 year post discharge among Part D enrollees. CONCLUSIONS: Only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees. There remain opportunities for improvement in medication adherence among patients with prescription drug coverage.

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Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

November 2015

Volume

8

Issue

6

Start / End Page

567 / 575

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Registries
  • Recurrence
  • Patient Readmission
  • Patient Discharge
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Goyal, A., de Lemos, J. A., Peng, S. A., Thomas, L., Amsterdam, E. A., Hockenberry, J. M., … Wang, T. Y. (2015). Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes, 8(6), 567–575. https://doi.org/10.1161/CIRCOUTCOMES.115.001650
Goyal, Abhinav, James A. de Lemos, S Andrew Peng, Laine Thomas, Ezra A. Amsterdam, Jason M. Hockenberry, Eric D. Peterson, and Tracy Y. Wang. “Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction.Circ Cardiovasc Qual Outcomes 8, no. 6 (November 2015): 567–75. https://doi.org/10.1161/CIRCOUTCOMES.115.001650.
Goyal A, de Lemos JA, Peng SA, Thomas L, Amsterdam EA, Hockenberry JM, et al. Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes. 2015 Nov;8(6):567–75.
Goyal, Abhinav, et al. “Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction.Circ Cardiovasc Qual Outcomes, vol. 8, no. 6, Nov. 2015, pp. 567–75. Pubmed, doi:10.1161/CIRCOUTCOMES.115.001650.
Goyal A, de Lemos JA, Peng SA, Thomas L, Amsterdam EA, Hockenberry JM, Peterson ED, Wang TY. Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes. 2015 Nov;8(6):567–575.

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

November 2015

Volume

8

Issue

6

Start / End Page

567 / 575

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Registries
  • Recurrence
  • Patient Readmission
  • Patient Discharge