The American journal of managed care
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To assess the effects of a nurse-led personalized care plan on the duration of olaparib therapy among patients with cancer. ⋯ A nurse-led personalized care approach effectively increased medication persistence among patients receiving olaparib for treatment of cancer, and the effect was more apparent among care plan patients who experienced symptom resolution or dose modification.
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To assess trends in the medical loss ratio (MLR) and understand how health insurance premiums in the large group market are driven by medical claims spending and insurer margins. ⋯ Medical spending is the primary driver of premiums in the large group market. Efforts to address growing health insurance premiums in the US will require consideration of how medical spending contributes to this growth.
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Cardio-kidney-metabolic (CKM) syndrome is a term to describe the interconnection between cardiovascular disease, type 2 diabetes, and chronic kidney disease. The National Health and Nutrition Examination Survey from 1999 to 2020 estimated that 25% of participants had at least 1 CKM condition. It is proposed that CKM syndrome originates in excess and/or dysfunctional adipose tissue, which secretes proinflammatory and prooxidative products leading to damaged tissues in arteries, the heart, and the kidney, and reduction in insulin sensitivity. ⋯ The American Heart Association suggests that CKM syndrome screening should include both biological factors and SDOH. Interventions in patients with stages 0 to 3 CKM syndrome focus on preventing future cardiovascular events by management of excess adiposity, mainly through diet and exercise in the early stages, then through pharmacological treatment of metabolic syndrome components in later stages. There is a general acceptance that treatment of CKM syndrome should involve a holistic approach to prevention, screening, and management to improve outcomes and reduce long-term morbidity and mortality.
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To examine the relationship between adoption of direct oral anticoagulants (DOACs) and health and cost outcomes for patients with nonvalvular atrial fibrillation. ⋯ More rapid adoption of newly approved nonvalvular atrial fibrillation treatments was associated with reduced stroke rates and high cost savings. Managed care organizations should consider how delays in the uptake of innovative medications impact health and economic outcomes.