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Mail-Order Pharmacy Use Could Improve
Patients' Medication Adherence, Study Says
Buying
mail-order medications may encourage patients to stick to their
doctor-prescribed medication regimen, new research suggests.
In a
first-of-its-kind study, researchers from UCLA and Kaiser Permanente's Division
of Research in Oakland, Calif. found that patients with diabetes, high blood
pressure or high cholesterol who ordered their medications by mail were more
likely to take them as prescribed by their doctors than did patients who
obtained them from a local pharmacy.
The study is
published online in the American Journal of Managed Care.
"The field of
medication adherence research typically focuses on patient factors for poor
adherence, leading to a 'blame the patient' approach for non-adherence," said
Dr. O. Kenrik Duru, assistant professor in the division of general internal
medicine and health services research at the David Geffen School of Medicine at
UCLA, and the study's lead researcher.
"Our work
helps to place this issue in a larger perspective," Duru added. "Our findings
indicate that mail-order pharmacies streamline the medication acquisition
process, which is associated with better medication adherence."
In a recent
survey, Kaiser Permanente members listed mail-order pharmacy among the top
benefits of managing their health via Kaiser Permanente's personal health
record, My Health Manager. More then 3.4 million members use My Health
Manager to conveniently view lab results, refill prescriptions, schedule
appointments and securely email their doctors.
For this
12-month study, the researchers analyzed 2006 and 2007 medication refill data
from 13,922 Kaiser Permanente members in Northern California. They defined "good
adherence" as having medication available and on hand at least 80 percent of the
time.
They found
that 84.7 percent of patients who received their medications by mail at least
two-thirds of the time stuck to their physician-prescribed regimen, versus 76.9
percent who picked up their medications at "brick and mortar" Kaiser Permanente
pharmacies.
"The results
were consistent for all three classes of medication, including medications to
control diabetes, high blood pressure, and high cholesterol," explained
co-investigator Julie A. Schmittdiel, PhD, a research scientist with the Kaiser
Permanente Division of Research.
"Our findings
suggest that there is a lot that health care systems can do to provide support
that makes it easier for patients to take care of themselves and do the right
thing."
Other
findings include:
u
After adjusting for
other variables, whites were more likely to use mail-order more than 2/3 of the
time (24.1 percent) than were Asian/Pacific Islanders (8.4 percent), Hispanics
(5.2 percent), blacks (4.0 percent), and people of mixed race (8.0 percent.
u
Mail-order pharmacy
users were more likely than local pharmacy users to have a financial incentive
to fill their prescriptions by mail (49.6 percent vs. 23.0 percent), and to live
a greater distance away from a local pharmacy (8.0 miles vs. 6.7 miles). An
example of a financial incentive is receiving a three-month supply of
medications for the cost of a two-month supply.
While other
research has examined the association between mail-order vs. local pharmacy
types and medication cost, this is the first to look at the relationship between
pharmacy type and adherence. Furthermore, it controls for differences in
medication days' supply and out-of-pocket costs between mail-order and local
pharmacy users, something other datasets don't include.
"In other
words, our study is able to isolate the use of mail-order pharmacies
specifically without the results being affected by differences in cost or in the
number of pills provided with each dispensing," Duru said.
The study
does have some limitations. For example, these findings need to be confirmed by
a randomized controlled trial. Still, this research suggests that increased
mail-order use to obtain medications could improve patients' adherence.
Grants from
the Centers for Disease Control and Prevention and the National Institute of
Diabetes and Digestive and Kidney Diseases funded this study.
02/24/10
'Herbal Insights' Debuts on PBS TV Series
The
American Botanical Council (ABC), America's leading nonprofit herbal research
and education organization, has teamed up with the producers of a public
television series to create "Herbal Insights," a new segment on popular herbs
and herb issues.
ABC founder
and executive director Mark Blumenthal has co-created and recorded "Herbal
Insights" segments for Healing Quest, a public television show co-hosted by
Olivia Newton-John and co-producers Judy Brooks and Roy Walkenhorst of
Lightbridge Productions in Sonoma, California.
The new
season's shows with the "Herbal Insights" segments began airing in select
markets on January 2, 2010, and are scheduled to run throughout the year.
The first
seven "Herbal Insights" provide brief profiles on the following herbs: chamomile
(Matricaria recutita), peppermint (Mentha x piperita), ginger (Zingiber
officinale), licorice (Glycyrrhiza glabra), marshmallow (Althaea officinalis),
senna (Senna alexandrina), and slippery elm (Ulma rubra) bark.
"We are
deeply grateful for the opportunity to work with the producers of Healing Quest
to distribute these short two-minute segments to public television audiences,"
said Blumenthal. "Being on public TV helps enhance ABC's nonprofit educational
mission to educate the public about the traditional uses and modern research on
herbs and medicinal plants."
Healing
Quest, now in its seventh season, covers many topics related to natural and
integrative health. The show frequently features interviews with noted leaders
in the natural health and consciousness movements, including author Deepak
Chopra, MD; integrative medicine pioneer Andrew Weil, MD; bestselling authors
Marianne Williamson and Joan Borysenko, PhD; holistic pediatrician Alan Greene,
MD, and others.
Healing Quest
is cleared for broadcast on 140 public television (PBS) stations across the
Unites States. Since its inception, Healing Quest has been the only weekly
national TV series focused entirely on integrative health and natural approaches
to optimum well-being.
Among the
show's underwriters, Healing Quest is supported by Traditional Medicinals, a
manufacturer of medicinal herbal teas and related herbal products; Bionorica, a
German producer of clinically-tested phytomedicinal products; and RFI
Ingredients, a supplier of herbs and other dietary ingredients for the food and
dietary supplement industries.
01/20/09
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