The American journal of managed care
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Randomized Controlled Trial
Impact of expanded carrier screening on health care utilization.
To evaluate potential consequences of expanded carrier screening (ECS) for reproductive risk on health care utilization among women who are not at increased reproductive risk. ⋯ These results suggest that ECS does not have unintended negative impacts on the health care system for the majority of patients who are not at increased reproductive risk.
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Randomized Controlled Trial
The spectrum of progressive fibrosis interstitial lung disease: clinical and managed care considerations.
Progressive fibrosing interstitial lung diseases (ILDs) encompass a wide range of diseases, including hypersensitivity pneumonitis, occupational diseases, granulomatous diseases, drug-induced diseases, and idiopathic pneumonitis. Given the vast number of progressive fibrosing ILDs and the disparities in clinical patterns and disease features, understanding their clinical and economic impact presents significant challenges. Historically, treatment options for progressive fibrosing ILDs include anti-inflammatory drugs and immunosuppressive. ⋯ In March 2020, nintedanib was approved by the FDA for the treatment of patients with chronic fibrosing ILDs with a progressive phenotype, becoming the first therapeutic agent to receive an indication for this set of diseases. The approval was based on data from the phase 3 randomized, double-blind, placebo-controlled, parallel-group INBUILD trial. Questions regarding the cost of medications, their effects on disease and comorbidities, patient selection, and combination strategies remain to be answered.
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Randomized Controlled Trial
Population-based breast cancer screening in a primary care network.
To assess the ability of a health information technology system to facilitate population- based breast cancer screening. ⋯ Population-based informatics systems can enable sustained increases in mammography screening rates beyond rates seen with office-based visit reminders.
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Randomized Controlled Trial
Impact of a managed controlled-opioid prescription monitoring program on care coordination.
Inappropriate opioid medication utilization has grown tremendously in recent years. Managed care organizations have the opportunity to identify potential opioid misuse and implement care coordination interventions. ⋯ This intervention provided action-able information to prescribers regarding member opioid utilization, in addition to available managed care resources. It resulted in significantly greater reductions in the number of prescribers, pharmacies, and prescriptions compared with a general information letter notifying prescribers of available managed care resources. Implementation of this intervention has the potential to enhance coordination of care for members potentially at risk for poor health outcomes.
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Randomized Controlled Trial
Effect of a patient activation intervention on hypertension medication optimization: results from a randomized clinical trial.
To examine the effect of a patient activation intervention with financial incentives to promote switching to a thiazide in patients with controlled hypertension using calcium channel blockers (CCBs). ⋯ This low-cost, low-intensity patient activation intervention resulted in increased rates of switching to a thiazide in those whose hypertension was controlled using another medication, suggesting that such interventions may be used to overcome medication optimization challenges, including clinical inertia.