Evidence map›Paper›PMID 40329025›Full record

ArticleJournal of general internal medicine2026

Filling Diabetes Medications Through VA or Medicare, or Both: Factors in Decision Making, Challenges, and Informational Needs.

Anna Hung, Abigail Shapiro, Hollis J Weidenbacher, Adrian D Brown, Greeshma M Thomas, Ellen B Lawrence, Katherine Van Loon, Theodore S Berkowitz, Karen Steinhauser, Valerie A Smith and 5 more

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Anna HungCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA. anna.hung@duke.edu.ORCID 0000-0002-0730-431X
Abigail ShapiroCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Hollis J WeidenbacherCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Adrian D BrownCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Greeshma M ThomasCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Ellen B LawrenceCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Katherine Van LoonCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Theodore S BerkowitzCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Karen SteinhauserCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Valerie A SmithCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Jeffrey T KullgrenCenter for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Angela FagerlinDepartment of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.
Shelby D ReedDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Matthew L MaciejewskiCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, NC, USA.
Carolyn T ThorpeCenter for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.

Funding

HSRD VA IK2 HX003359VA RCS 10-391
6 · The paper itself

Abstract

backgroundVeterans' dual use of VA and Medicare Part D to fill diabetes medications is common and has advantages as well as disadvantages.

objectiveTo understand the factors Veterans and their care partners consider when choosing whether to fill their diabetes medications through VA only, Part D only, or both, as well as their medication acquisition challenges and informational needs. APPROACH: Semi-structured interviews between April and September 2023. Transcripts were analyzed via descriptive content analysis with deductive and inductive approaches.

participantsIn total, 24 Veterans and 12 care partners. MAIN MEASURES: Drivers of choice, medication acquisition challenges, and informational needs that Veterans and care partners report when choosing where to fill their diabetes medications. KEY

resultsCost, followed by formulary access, were main drivers of where Veterans and their care partners chose to fill their diabetes medications. Drive time, convenience, and preference for a particular provider were also considered, and care partners expressed a desire to streamline all of a Veteran's care to VA or Medicare for convenience and time savings. Veterans and care partners had mixed experiences with dual use, with some expressing frustration related to communication challenges between providers and incompatibilities between different health systems. Health-related risks associated with dual use were rarely mentioned. Veteran and care partner informational needs included relative costs and availability of medications on the formularies, and there was a preference to have direct access to information alongside telephone-based pharmacy support.

conclusionsCost and then medication access as well as drive time, convenience, and preference for a particular provider influenced Veteran and care partner choices on where to fill medications. Care partners often preferred one system. Differences and incompatibilities between VA and Medicare at times led to frustration and challenges filling medications. Information and support are needed to help Veterans and their care partners.

Indexed as

Decision MakingDiabetes MellitusHypoglycemic AgentsMedicare Part DUnited States Department of Veterans AffairsVeteransAgedFemaleHumansMaleMiddle AgedUnited StatesHypoglycemic Agentsdecision makingdiabetesmedicarepharmacyprescription insuranceveterans

Identifiers

PMID40329025
PMCPMC12855650

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.