ArticleMedical care2015
Health care system-level factors associated with performance on Medicare STAR adherence metrics in a large, integrated delivery system.
Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Strategies aiming to improve statin therapy adherence in older adults: a systematic review.BMC geriatrics · 2024Pooled it
- Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: A systematic literature review.Journal of managed care & specialty pharmacy · 2023Pooled it
- Impact of issuing longer- versus shorter-duration prescriptions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Trial
- A Motivational Interviewing Intervention by Pharmacy Students to Improve Medication Adherence.Journal of managed care & specialty pharmacy · 2017Trial
- Rationale and design of the Study of a Tele-pharmacy Intervention for Chronic diseases to Improve Treatment adherence (STIC2IT): A cluster-randomized pragmatic trial.American heart journal · 2016Trial
- Antihypertensive Medication Patterns in Patients with Hypertension that is Harder to Control: Insights from the EnligHTN Study.Advances in therapy · 2026Article
- Group-based trajectory modeling to identify longitudinal patterns and predictors of adherence among older adults on concomitant triple therapy (oral antidiabetic, renin-angiotensin-system antagonists, statins).Journal of managed care & specialty pharmacy · 2025Article
- Suitability of Measures of Pharmacy-Based Medication Adherence for Routine Clinical Use Among Patients with Chronic Diseases: A Systematic Review.Patient preference and adherence · 2025Review
- Article
- Costs of Prescription Drugs for Children and Parental Adherence to Long-Term Medications.JAMA network open · 2023Article
- Evaluating Adherence to Concomitant Diabetes, Hypertension, and Hyperlipidemia Treatments and Cardiovascular Outcomes Among Elderly Patients Using Marginal Structural Modeling.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2022Article
- Comparison of measures of medication adherence from pharmacy dispensing and insurer claims data.Health services research · 2022Article
- Association of Low-Density Lipoprotein Testing After an Atherosclerotic Cardiovascular Event with Subsequent Statin Adherence and Intensification.The American journal of medicine · 2022Article
- Twelve month oral contraceptive pill prescriptions: Role of policy mandates on utilization.Exploratory research in clinical and social pharmacy · 2022Article
- Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Impact of implementing electronic prior authorization on medication filling in an electronic health record system in a large healthcare system.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Are patients more adherent to newer drugs?Health care management science · 2020Article
- Association of Potentially Modifiable Diabetes Care Factors With Glycemic Control in Patients With Insulin-Treated Type 2 Diabetes.JAMA network open · 2020Article
- Quantifying Social Reinforcement Among Family Members on Adherence to Medications for Chronic Conditions: a US-Based Retrospective Cohort Study.Journal of general internal medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe Centers for Medicare and Medicaid Services provide significant incentives to health plans that score well on Medicare STAR metrics for cardiovascular disease risk factor medication adherence. Information on modifiable health system-level predictors of adherence can help clinicians and health plans develop strategies for improving Medicare STAR scores, and potentially improve cardiovascular disease outcomes.
objectiveTo examine the association of Medicare STAR adherence metrics with system-level factors. RESEARCH
designA cross-sectional study. SUBJECTS: A total of 129,040 diabetes patients aged 65 years and above in 2010 from 3 Kaiser Permanente regions. MEASURES: Adherence to antihypertensive, antihyperlipidemic, and oral antihyperglycemic medications in 2010, defined by Medicare STAR as the proportion of days covered ≥ 80%.
resultsAfter controlling for individual-level factors, the strongest predictor of achieving STAR-defined medication adherence was a mean prescribed medication days' supply of > 90 days (RR=1.61 for antihypertensives, oral antihyperglycemics, and statins; all P < 0.001). Using mail order pharmacy to fill medications > 50% of the time was independently associated with better adherence with these medications (RR = 1.07, 1.06, 1.07; P < 0.001); mail order use had an increased positive association among black and Hispanic patients. Medication copayments ≤ $10 for 30 days' supply (RR = 1.02, 1.02, 1.02; P < 0.01) and annual individual out-of-pocket maximums ≤ $2000 (RR = 1.02, 1.01, 1.02; P < 0.01) were also significantly associated with higher adherence for all 3 therapeutic groupings.
conclusionsGreater medication days' supply and mail order pharmacy use, and lower copayments and out-of-pocket maximums, are associated with better Medicare STAR adherence. Initiatives to improve adherence should focus on modifiable health system-level barriers to obtaining evidence-based medications.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.