It is common to have a lot of priority when you visit a doctor. Perhaps it is relief for worsening pickleball injuries, a long cough or finally checking out strange moles.You really have to do it). Often the risk of our drugs is not high in the priority list, but it will.
There is a risk of any drug, but understanding and managing these risks is more important than other prescription drugs. High risk (or depletion) drugs (HRMS) The patient’s characteristics (for example, age, chronic diseases, etc.) or misuse causes extreme risks. Therefore, HRM requires a prescription and health system to use various things. Practice and equipment Evaluate and alleviate the risk of patient safety improvement.
Considering their prevalence Intermediate interest About HRM’s prescription practices and implications for health care.
Recent study
In the published study Jama Network OpenEvalues at Harvard University and Boston University compared the HRM prescription trends between traditional service paid Medicare (TM) and Medicare Wood (MAD), which is a personal management plan for the qualified person of Medicare and publicly funded through public payment contracts.
To complete the analysis, the author compared more than 13.7 million beneficiaries from the samples of 2013-2018. This study includes Medicare Master Beneficiary Summary File, Social Vilnerability Index, US Management and Budget Office and Medicare Part D MAS
For major measures, this study depends on the use of high -risk pharmaceuticals in medical effect data and information sets (HEDIS) and elderly metrics.. As a main result, the author considered the number of HRM prescribed to qualified registrants. As a secondary result, the author has seen the ratio of the elderly registrants prescribed at least 1 hour per year. Other results include the ratio of registrants who received two or more HRMs or the same HRM twice a year in the same year.
In addition to the main variables of Medicare Insurance (ie, TM vs. MA registration), this study has investigated a number of covariates. Researchers considered patient health indicators considering age, gender, race and ethnicity, dual validation, dual validation, duality, social vulnerability, low -income subsidies of Medicare and the number of non -HRM drugs.
The author first used a linear regression to configure the first model, and after describing the covenant and other effects (fixed and random), the adjusted speed of the unique HRM prescription was drawn. After the secondary results were shown similarly, sensitivity analysis was completed according to various criteria.
Ultimately, the study found that HRM usage rate decreased annually every study period (2013-2018). This is true for both TM and MA. In line with the previous observed trend, the use of HRM in MA was quite lower than TM, but the gap between them was narrowed. In the last year of the study period, the use of HRM in TM was still 56.9 HRM (per 1000 beneficiaries) compared to MA’s 41.5. Similar patterns were observed in the secondary results analysis of the registration ratio prescribed at least one hour per year. Compared to TM, MA has lowered the adjustment rate of beneficiaries who prescribed at least 1 hour (3.9%) to 5.3%in TM. Compared to the patient’s characteristics, this study observed higher HRM usage rates for women, American Indians, or Alaska Aboriginal or white, and white.
conclusion
The author pays attention to some major restrictions, including analysis restrictions on drugs identified by DAE measurement during the study period. This study also couldn’t assess the degree of clinically appropriate HRM prescriptions. The author also explains that this work is limited using MA as a single exposure and only the filled prescriptions are included in the analysis.
Despite these limitations, this study affects both medical practical and medical policies. According to this study, a specific population (women, American Indians, or Alaska natives and white individuals) has received high frequency HRMs, and it is necessary to better understand how the prescriber evaluates the clinical presentation of this population. The results of this study also emphasizes how the mechanism responsible for the overall reduction of HRM use in TM is not known. The author recommends that the Medicare & Medicaid Services Center will explore additional means (eg, bundled HRM fare into repayment models) to narrow the gap between TM and MA compared to the HRM ratio.
Given the potential of damage, further studies on HRM drug management strategies are essential elements that improve patient treatment and safety in the elderly.
PEPREC is a team of health economists, public health researchers and policy analysts who support VA efforts to improve the lives of Veterans by using advanced quantum methods that are mostly funded by QUERI in the Veterans Health Bureau.
