Mail-Order Pharmacy Use and Medication Adherence Among Older Adults with Diabetes

老年糖尿病患者的邮购药房使用和药物依从性

基本信息

批准号：
7939884
负责人：
OBIDIUGWU KENRIK, DURU
金额：
$ 12.12万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7939884
关键词：
Address Adherence Adult Affect Age American Antihypertensive Agents Area Award Awareness Basic Science Behavior Blood Pressure Caring Chronic Disease Clinical Clinical Trials Code Community Pharmacy Complications of Diabetes Mellitus Computer Assisted Control Groups Cost Savings Data Data Analyses Development Plans Diabetes Mellitus Disadvantaged Drug Prescriptions Educational Materials Elderly Employee Enrollment Extramural Activities Funding Generic Drugs Goals Health Health Benefit Health Planning Healthcare Household Income Intervention Intervention Studies K-Series Research Career Programs Lead Leadership Lipids Location Low Income Population Low income Mail Order Mails Measures Medicare Mentors Minority Modeling Names Office Nursing Oral Outcome Outpatients Oxidoreductase Participant Patients Pharmaceutical Preparations Pharmacists Pharmacy facility Phase Principal Investigator Process Public Health Publishing Qualitative Research Questionnaires Randomized Controlled Trials Reading Recording of previous events Research Research Personnel Resources Risk Factors Sampling Savings Self Efficacy Site Social Work Statistical Models Subgroup Techniques Telephone Interviews Testing Time Translating Translational Research Translations Travel United States Centers for Medicare and Medicaid Services United States National Institutes of Health Vulnerable Populations Work beneficiary career career development cost design diabetic evidence base health care delivery improved inhibitor/antagonist interest intervention effect literacy medication compliance novel novel strategies pharmacy benefit prevent primary outcome public health relevance secondary outcome skills skills training therapy design therapy development uptake

项目摘要

DESCRIPTION (provided by applicant): Poor medication adherence is a fundamental, unsolved obstacle preventing the "real-world" translation of clinical trial findings that have been shown to reduce diabetes-related complications in older adults. To realize these health benefits in clinical settings, we need interventions that lead to sustainable improvements in medication adherence. The use of mail-order pharmacies may represent such an approach, that overcomes financial and logistical barriers to medication acquisition and leads to improved medication adherence by older adults. The proposed career development award has 3 specific aims: 1) to evaluate whether the use of mail- order pharmacies as compared with local pharmacies is associated with greater adherence to diabetes-related medications (oral antiglycemics, antihypertensives, and HMGCoA reductase inhibitors ("statins"); a higher proportion of generic as compared to brand name diabetes-related medications; and lower out-of-pocket medication costs among Medicare Part D enrollees; 2) to develop low-literacy intervention materials intended to increase mail-order pharmacy use among low-income Part D enrollees and test them in a feasibility trial, and 3) to develop additional quantitative and qualitative research skills necessary to succeed as an independent investigator conducting translational research. Dr. Duru will work closely with his research mentors including Dr. Carol Mangione, the Principal Investigator of the UCLA Resource Center for Minority Aging Research (RCMAR), to conduct the proposed research. As part of the proposed career development plan, Dr. Duru will acquire skills in the use of statistical techniques, including instrumental variable analyses, to maximize causal inference in studies using observational data. He will apply these techniques in the analyses described in Specific Aim #1. He will also develop expertise in the area of healthcare implementation in real-world settings, and apply this in the activities described in Specific Aim #2. This proposed K award will provide Dr. Duru with the training and skills needed to become an independent investigator, conducting intervention research that results in tangible improvements in the health of vulnerable older adults. PUBLIC HEALTH RELEVANCE: In this study we will evaluate whether Medicare beneficiaries with diabetes are more likely to consistently take their medications if they receive them through the mail as compared to at a local pharmacy. We will also develop and test educational and enrollment materials to help low-income Medicare beneficiaries successfully sign up for medication delivery by mail.

描述（由申请人提供）：药物依从性不佳是一种基本的，未解决的障碍，阻止了临床试验发现的“现实世界”翻译，这些发现已被证明可减少老年人与糖尿病有关的并发症。为了在临床环境中实现这些健康益处，我们需要采取干预措施，从而导致药物依从性的可持续改善。邮购药房的使用可能代表了这种方法，它克服了药物获取的财务和后勤障碍，并导致老年人改善了药物依从性。拟议的职业发展奖具有3个具体目的：1）评估与当地药房相比使用邮购药房是否与与糖尿病相关的药物（口服抗糖菌，抗生素敏感剂，抗二激素，抗二激素，和HMGCOA还原酶抑制剂及其较高的糖尿病）相比； Medicare D部分的成本； 2）开发低文字干预材料，旨在增加低收入D部分的邮购药房使用，并在可行性试验中对其进行测试，3）开发出额外的定量和定性研究技能，以成功地作为独立研究人员进行转换。杜鲁博士将与他的研究导师紧密合作，包括加州大学洛杉矶分校少数民族老化研究中心（RCMAR）的主要研究员卡罗尔·曼吉恩（Carol Mangione）博士，以进行拟议的研究。作为拟议的职业发展计划的一部分，杜鲁博士将获得使用统计技术的技能，包括工具变量分析，以最大程度地提高使用观察数据的研究中的因果推断。他将在特定目标1中描述的分析中应用这些技术。他还将在现实世界中的医疗保健实施领域发展专业知识，并将其应用于特定目标2中所述的活动。拟议的K奖将为杜鲁博士提供成为独立研究人员所需的培训和技能，进行干预研究，从而导致脆弱的老年人健康的切实改善。公共卫生相关性：在这项研究中，我们将评估如果与当地药房相比，如果他们通过邮件接收药物，患有糖尿病的医疗保险受益人是否更有可能持续服用药物。我们还将开发和测试教育和入学材料，以帮助低收入的医疗保险受益人成功地通过邮件注册药物。