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目标教育对消费者导向型医疗保健参保者用药持续性和仿制药替代的影响。

The influence of targeted education on medication persistence and generic substitution among consumer-directed health care enrollees.

机构信息

Office of Evidence-Based Pharmacy Benefit Design, Express Scripts Inc., One Express Way, St. Louis, MO 63121, USA.

出版信息

Health Serv Res. 2009 Dec;44(6):2079-92. doi: 10.1111/j.1475-6773.2009.01023.x. Epub 2009 Sep 23.

Abstract

OBJECTIVE

To evaluate an educational outreach among consumer-directed health plan (CDHP) enrollees on medication persistence and lower-cost generic substitution within four chronic medication therapies.

STUDY SETTING

A cross-sectional analysis using pharmacy claims data from a national employer group that began offering a CDHP in 2006 and implemented an educational outreach to some CDHP enrollees in 2007 was used.

METHODS

The intervention group was comprised of CDHP enrollees who received education outreach and was compared with CDHP enrollees without the educational outreach. Adjusted and unadjusted medication persistence and lower-cost generic substitutions were compared between groups.

PRINCIPAL FINDINGS

There was no difference in medication persistence between groups. CDHP enrollees with the educational outreach were more likely to have converted to lower-cost generic alternative antihypertensive medication compared with CDHP enrollees without the educational outreach (OR(adj)=29.82, 95 percent CI=4.41-201.93).

CONCLUSION

Educational outreach directed to CDHP enrollees was associated with increases in lower-cost generic alternatives with no change in patients' chronic medication use. However, considerable opportunity exists to assist CDHP enrollees in making sound health care decisions.

摘要

目的

评估针对消费者导向型健康计划(CDHP)参保者的教育外展活动,以了解其在四种慢性药物治疗中药物持续使用情况和低成本通用替代药物的使用情况。

研究设置

使用来自全国雇主群体的药房索赔数据进行了一项横断面分析,该雇主群体于 2006 年开始提供 CDHP,并于 2007 年对部分 CDHP 参保者实施了教育外展活动。

方法

干预组由接受教育外展的 CDHP 参保者组成,并与未接受教育外展的 CDHP 参保者进行了比较。比较了两组之间的药物持续使用情况和低成本通用替代药物的使用情况。

主要发现

两组之间的药物持续使用情况没有差异。与未接受教育外展的 CDHP 参保者相比,接受教育外展的 CDHP 参保者更有可能将降压药物转换为低成本通用替代药物(调整后 OR(adj)=29.82,95%CI=4.41-201.93)。

结论

针对 CDHP 参保者的教育外展活动与低成本通用替代药物的使用增加有关,而患者慢性药物使用情况没有变化。然而,为 CDHP 参保者提供帮助以做出明智的医疗保健决策的机会仍然很大。

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