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VBCR - August 2015, Volume 4, No 4 - Value Propositions

Medicaid beneficiaries with systemic lupus erythematosus (SLE) who demonstrated poor adherence to their medications had increased numbers of emergency department visits and hospital admissions according to a report by Candace H. Feldman, MD, MPH, of the Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA, and colleagues.

Using US Medicaid data from 2000 to 2006, researchers identified patients with SLE aged 18 to 64 years who were new users of hydroxychloroquine (HCQ) or immunosuppressive (IS) medications and measured adherence for 1 year. Multivariable Poisson regression models were used to examine the association between nonadherence (MPR <80%) and emergency department visits and hospitalizations in the subsequent year. Adjustments were made for sociodemographics and comorbidities.

The authors concluded that among this cohort of patients with SLE, nonadherence to HCQ and IS medications was common and was associated with significantly higher subsequent acute care utilization and costs. In this at-risk patient group, interventions to promote adherence could improve patient outcomes and reduce acute care utilization and costs. Overall, nonadherence accounts for more than $100 billion a year in preventable healthcare costs in the United States. Feldman CH, et al. Arthritis Care Res (Hoboken). Published online: June 19, 2015.

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Last modified: August 26, 2015
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