ArticleThe American journal of managed care2014
Medicare Star excludes diabetes patients with poor CVD risk factor control.
Article in The American journal of managed care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 22 citations in OpenAlex.
- Solving racial/ethnic disparities associated with Medicare Part D Star Ratings.Current medical research and opinion · 2023Article
- Effects of Part D Star Ratings on racial and ethnic disparities in health care costs.Exploratory research in clinical and social pharmacy · 2023Article
- Racial and ethnic disparities due to Medicare Part D Star Ratings criteria among kidney transplant patients with diabetes, hypertension, and/or dyslipidemia.Journal of managed care & specialty pharmacy · 2022Article
- Increasing Equity While Improving the Quality of Care: JACC Focus Seminar 9/9.Journal of the American College of Cardiology · 2021Review
- Technology-Enabled Outreach to Patients Taking High-Risk Medications Reduces a Quality Gap in Completion of Clinical Laboratory Testing.Population health management · 2020Article
- Identifying Preanalytic and Postanalytic Laboratory Quality Gaps Using a Data Warehouse and Structured Multidisciplinary Process.Archives of pathology & laboratory medicine · 2019Article
- The Effect of Age and Comorbidities on the Association Between the Medicare STAR Oral Antihyperglycemic Adherence Metric and Glycemic Control.Journal of managed care & specialty pharmacy · 2018Observational
- Effect of Out-of-Pocket Cost on Medication Initiation, Adherence, and Persistence among Patients with Type 2 Diabetes: The Diabetes Study of Northern California (DISTANCE).Health services research · 2018Observational
- Relationships between Medication Adherence and Cardiovascular Disease Risk Factor Control in Elderly Patients with Diabetes.Pharmacotherapy · 2017Article
- Is There a Relationship Between Part D Medication Adherence and Part C Intermediate Outcomes Star Ratings Measures?Journal of managed care & specialty pharmacy · 2016Article
- A Tale of Two Patients: Patient-Centered Approaches to Adherence as a Gateway to Reducing Disparities.Circulation · 2016Article
- Impact on glycated haemoglobin of a biological response-based measure of medication adherence.Diabetes, obesity & metabolism · 2015Article
- Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.Healthcare (Amsterdam, Netherlands) · 2015Article
- Health care system-level factors associated with performance on Medicare STAR adherence metrics in a large, integrated delivery system.Medical care · 2015Article
- Racial and ethnic disparities associated with the measure for drug-drug interactions among Medicare beneficiaries.Journal of the American Pharmacists Association : JAPhAArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectivesCMS recently added medication adherence to antihypertensives, antihyperlipidemics, and oral antihyperglycemics to its Medicare Star quality measures. These CMS metrics exclude patients with <2 medication fills (ie, "early nonadherence") and patients concurrently taking insulin. This study examined the proportion of patients with diabetes prescribed cardiovascular disease (CVD) medications excluded from Star adherence metrics and assessed the relationship of both Star-defined adherence and exclusion from Star metrics with CVD risk factor control. STUDY
designCross-sectional, population-based analysis of 129,040 patients with diabetes aged ≥65 years in 2010 from 3 Kaiser Permanente regions.
methodsWe estimated adjusted risk ratios to assess the relationship between achieving Star adherence and being excluded from Star adherence metrics, with CVD risk factor control (glycated hemoglobin [A1C]<8.0%, low-density lipoprotein cholesterol [LDL-C]<100 mg/dL, and systolic blood pressure [SBP]<130 mm Hg) in patients with diabetes.
resultsStar metrics excluded 27% of patients with diabetes prescribed oral medications. Star-defined nonadherence was negatively associated with CVD risk factor control (risk ratio [RR], 0.95, 0.84, 0.96 for A1C, LDL-C, and SBP control, respectively; P<.001). Exclusion from Star metrics due to early nonadherence was also strongly associated with poor control (RR, 0.83, 0.56, 0.87 for A1C, LDL-C, and SBP control, respectively; P<.001). Exclusion for insulin use was negatively associated with A1C control (RR, 0.78; P<.0001).
conclusionsMedicare Star adherence measures underestimate the prevalence of medication nonadherence in diabetes and exclude patients at high risk for poor CVD outcomes. Up to 3 million elderly patients with diabetes may be excluded from these measures nationally. Quality measures designed to encourage effective medication use should focus on all patients treated for CVD risk.
Indexed as
Identifiers
25741874PMC4641517W115547701What OpenQuestion holds
Registered trials
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