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Related Experiment Videos

Challenges of program implementation in a managed care environment: a case study in measuring medication persistence.

Blake Christiansen1

  • 1Aetna Pharmacy Management, 6430 S. Fiddler's Green Circle, Suite 200, Englewood, CO 80111, USA. ChristiansenBW@aetna.com

Journal of Managed Care Pharmacy : JMCP
|April 21, 2006
PubMed
Summary

Effective disease management for depression requires medication persistence. Prescription claims data, analyzed by managed care pharmacists, helps identify adherence issues, improving patient outcomes in managed care settings.

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Area of Science:

  • Health Services Research
  • Pharmacoeconomics
  • Clinical Pharmacy

Background:

  • Successful management of depression hinges on consistent medication adherence.
  • Physicians often lack direct access to patient medication consumption records.
  • Managed care environments present unique challenges for disease management implementation.

Purpose of the Study:

  • To outline the challenges encountered during the implementation of a disease management program.
  • To highlight the role of managed care pharmacists in monitoring medication persistence.
  • To illustrate key factors for designing effective disease management programs.

Main Methods:

  • Utilized prescription claims databases to track medication refill dates and quantities.
  • Developed visual representations of prescription data for physician review.

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  • Analyzed consumption patterns to identify potential adherence issues.

    • Main Results:

    • Prescription claims data visualization enabled physicians to assess medication persistence.
    • Identified patterns such as noncontinuous treatment, low usage, and nonpersistence.
    • Aetna Inc.'s experience provided insights into program design and implementation factors.

    Conclusions:

    • Managed care pharmacists can leverage prescription data to identify adherence problems.
    • Visual data representations are valuable tools for assessing medication persistence.
    • Disease management programs require comprehensive data analysis, considering clinical context.