Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA.
College of Medicine, The Ohio State University, Columbus, OH 43210, USA.
Int J Environ Res Public Health. 2023 Feb 17;20(4):3613. doi: 10.3390/ijerph20043613.
Sodium glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide 1 receptor (GLP-1) agonists are recommended for patients with type two diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) to reduce cardiovascular-related mortality. The objective of this study was to evaluate a telehealth targeted medication review (TMR) program to identify patients for uptake of these evidence-based medications.
This was an observational descriptive study of a TMR program for Medicare-enrolled, Medication Therapy Management-eligible patients in one insurance plan. Prescription claims and patient interviews identified individuals who would benefit from SGLT-2 inhibitors or GLP-1 agonists. Facsimiles were sent to providers of patients with educational information about the targeted medications. Descriptive statistics described characteristics and proportion of patients prescribed targeted medications after 120 days. Bivariate statistical tests evaluated associations between age, sex, number of medications, number of providers, and poverty level with adoption of targeted medications.
A total of 1106 of 1127 had a facsimile sent to their provider after a conversation with the patient. Among patients with a provider facsimile, 69 (6%) patients filled a prescription for a targeted medication after 120 days. There was a significant difference in age between individuals who started a targeted medication (67 ± 10 years) compared with patients who did not (71 ± 10 years) ( = 0.001).
A TMR efficiently identified patients with T2D and ASCVD or HF who would benefit from evidence-based medications. Although younger patients were more likely to receive these medications, the overall uptake of these medications within four months of the intervention was lower than expected.
钠-葡萄糖共转运蛋白 2（SGLT-2）抑制剂和胰高血糖素样肽 1 受体（GLP-1）激动剂被推荐用于 2 型糖尿病（T2D）和动脉粥样硬化性心血管疾病（ASCVD）或心力衰竭（HF）患者，以降低心血管相关死亡率。本研究的目的是评估远程医疗靶向药物审查（TMR）计划，以确定接受这些基于证据的药物的患者。
这是一项针对医疗保险参保、药物治疗管理合格患者的 TMR 计划的观察性描述性研究，该计划属于一个保险计划。通过处方索赔和患者访谈确定了受益于 SGLT-2 抑制剂或 GLP-1 激动剂的个体。向患者的提供者发送传真，提供有关靶向药物的教育信息。描述性统计描述了在 120 天后接受靶向药物治疗的患者的特征和比例。双变量统计检验评估了年龄、性别、药物数量、提供者数量和贫困水平与采用靶向药物之间的关联。
在与患者交谈后，共有 1106 名患者中的 1127 名收到了传真。在收到提供者传真的患者中，有 69 名（6%）患者在 120 天后开了靶向药物处方。开始靶向药物治疗的个体（67 ± 10 岁）与未开始治疗的患者（71 ± 10 岁）之间的年龄差异有统计学意义（ = 0.001）。
TMR 有效地确定了患有 T2D 和 ASCVD 或 HF 的患者，他们将受益于基于证据的药物。尽管年轻患者更有可能接受这些药物，但在干预后四个月内这些药物的总体使用率低于预期。
