Research Roundup: Medication Adherence, Performance At Community Health Centers

Each week KHN reporter Christian Torres compiles a selection of recently released health policy studies and briefs.

Archives of General Psychiatry: Effects of Medicare Part D Coverage Gap On Medication And Medical Treatment Among Elderly Beneficiaries With Depression -- For people diagnosed with depression, it's important that they adhere to their medication regimen so that they avoid recurrent episodes. But because of Medicare's Part D coverage gap, financially burdened seniors might not take their prescriptions as recommended. This study looked at Medicare beneficiaries diagnosed with depression in 2007. Those falling into the Part D gap reduced their monthly antidepressant use by 12.1 percent, while those who had at least generic drug coverage reduced their monthly use by 6.9 percent. These disruptions in medication use "could place older adults in harm's way," the authors write (Zhang et al, 7/2)

American Journal of Preventive Medicine: Federally Quali?ed Health Centers And Private Practice Performance On Ambulatory Care Measures --  Federally qualified health centers and similar community facilities are expected to carry a large share of the burden from the health law's expansion of insurance coverage. This study compares such providers to private practice primary care on 18 different quality measures. Overall, FQHCs and FQHC-like providers performed evenly with private practice, but they also performed better in areas including depression and heart disease treatment. The researchers write that the findings "can provide policymakers with some reassurance as to the quality of chronic disease and preventive care" at community health centers (Goldman et al, 7/10).

Archives of Internal Medicine: Effect Of A Pharmacist Intervention On Clinically Important Medication Errors After Hospital Discharge: A Randomized Trial -- Ensuring patients understand and stick to their medication regimen after they leave the hospital is an important part of improving outcomes and avoiding readmissions. One strategy is to provide direct contact with a pharmacist who counsels the patient and follows up via telephone. Researchers compared this intervention to the usual discharge care and found no significant difference in outcomes. Both patient groups averaged around the same number of adverse drug events in the 30 days after discharge; those with extra help had only a slight improvement in the number of medication errors that could lead to an adverse event. The researchers concluded that more-intensive care, including further follow-up with patients, may be necessary (Kripalani et al, 7/3).

Here is a selection of excerpts from news coverage of other recent research:

Medscape: Standardized Asthma Care For Kids May Not Improve Outcomes
Emergency departments (EDs) that use evidence-based standardized protocols (EBSPs) to treat children with asthma have similar rates of hospital admissions as EDs that do not use EBSPs, according to a new Canadian study. The findings were published online July 9 in the Archives of Pediatric Adolescent Medicine (Garcia, 7/9).

Medscape: Use Of Generic Drugs Reduces Costs Of AIDS Relief
Since its inception nearly a decade ago, a US program for supplying AIDS medications to the developing world has grown significantly. Meanwhile, costs of treatment per patient have dramatically fallen. The primary reason? The increasing availability of generic antiretroviral drugs, according to a review article published in the July issue of Health Affairs. The President's Emergency Plan for AIDS Relief (PEPFAR) was set up in 2003 with the aim of supporting prevention, treatment, and care efforts in 15 focus countries in the developing world (Fox, 7/9).

Medscape/Reuters: On-Screen Smoking May Turn Teens On To Cigarettes
Youths who watch a lot of movies with cigarette-smoking characters -- whether the films are rated R or PG-13 -- are more likely to start smoking themselves, researchers suggest in a new study out Monday. The report's lead author said the finding supports the idea that it's the smoking itself -- and not the sex, profanity or violence that may go along with it in certain films -- that influences youths to take up the habit (Pittman, 7/9).

Reuters: Patients Avoid Disagreeing With Doctor, May Ignore Advice
Most people are unwilling to contradict their doctor in discussions on medical treatment, according to a U.S. survey showing that most want a say in treatment decisions or they may end up not following the advice. The findings, which appeared in the Archives of Internal Medicine, are based on an online panel of 1,340 adults who were told to imagine they had heart disease and then asked how they wanted to be involved in their own treatment (Pittman, 7/12).

Modern Healthcare: EHR Use Leads To Improved Image Review: Study
Using an electronic health record to review portal images can lead to improvements in patient care and safety, according to a new study. The study—results of which are published in the July issue of the Journal of the American College of Radiology—found that use of an EHR improves compliance with record-keeping and timeliness policies. Better compliance, in turn, can improve patient care and safety, the authors said (Lee, 7/10).

Reuters: Expensive, Newer Stents Not Better For All -- Study
Many heart patients get newer, pricey stents inserted during artery-clearing procedures, even if it's not clear they would be worse off with more basic, less expensive stents, a new study suggests. The new findings are an example of ways technology gets overused and at times misused in healthcare, according to a commentary accompanying the study (Pittman, 7/9).