The American journal of managed care
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To examine the impact of initial maintenance therapy (IMT) type (inhaled corticosteroid [ICS] vs fixed-dose combination of ICS and long-acting β agonist [ICS/LABA]) on trajectories of adherence among older adults (≥ 65 years) with coexisting asthma and chronic obstructive pulmonary disease (COPD), known as asthma-COPD overlap (ACO). ⋯ Real-world evidence suggests that using ICS/LABA for IMT may decrease the likelihood of persistent low adherence over time among older adults with ACO compared with ICS monotherapy.
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To assess the effectiveness of a proactive provider intervention in prompting prior authorization (PA) submissions or provider response prior to PA expiration for medically complex Medicaid patients. ⋯ Proactive outreach resulted in a greater percentage of PA submissions and a significantly reduced time to PA submission. These findings provide important information for payers in guiding clinical programs to enhance continuity of care among at-risk populations.
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Most transparency tools are provided by individual insurers for enrollees shopping for services within their networks. This paper seeks to understand the impact of a marketwide price transparency tool with an embedded randomized experiment to offer provider-level charge information. ⋯ Our findings confirm aspects of price search theory that have been developed by studying other industries and may prove instructive for further study of price transparency tools.
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Hypertension is among the most commonly managed diseases in general practice. Therapeutic inertia could be responsible for the vast majority of cardiovascular events in patients with hypertension. The present study was conducted to explore views and opinions of clinicians involved in providing health care services to patients with hypertension in Palestine and achieve formal consensus on promoters of the phenomenon of therapeutic inertia from their point of view. ⋯ Findings of this study could inform policy and decision makers to devise strategies to eliminate or reduce therapeutic inertia in managing hypertension in Palestinian clinical practice. Future studies are needed to determine whether such strategies can improve outcomes of patients with hypertension.
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Therapeutic/clinical inertia is thought to be responsible for up to 80% of cardiovascular events. This study was conducted as a comprehensive scoping and bibliometric analysis of peer-reviewed scholarly documents reporting on factors associated with therapeutic/clinical inertia in caring for patients with hypertension. Additionally, this study identified the factors associated with therapeutic/clinical inertia in hypertension. ⋯ This scoping and bibliometric study provides insights into the width and depth of scholarly peer-reviewed documents on factors associated with therapeutic/clinical inertia in caring for patients with hypertension. Findings of this study could be helpful in shaping future directions of research into therapeutic/clinical inertia in hypertension.