Receipt of Medicare Part D comprehensive medication reviews in older adults with dementia.

IF 2.3 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of managed care & specialty pharmacy Pub Date : 2025-03-01 DOI:10.18553/jmcp.2025.31.3.296

Antoinette B Coe, Jonathan Martindale, Julie P W Bynum

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引用次数: 0

Abstract

Background: Older adults with Alzheimer disease and related dementias (ADRDs) are at high risk for medication-related problems. Comprehensive medication reviews (CMRs), required in Medicare Part D medication therapy management (MTM) programs, aim to optimize medication use and reduce adverse events. Individual factors related to MTM eligibility and CMR receipt among beneficiaries with ADRD are unknown.

Objective: To examine MTM eligibility and CMR receipt among older adults with ADRD compared with those without.

Methods: This retrospective, cross-sectional study included 2014 Health and Retirement Study participants aged at least 65 years, with continuous Medicare fee-for-service and Part D coverage. Outcomes were MTM eligibility and CMR receipt in 2014 or 2015. Our primary independent variable was presence of diagnosed ADRD. Covariates included sociodemographic characteristics, health conditions, and functional limitations. Weighted descriptive and bivariate statistics and multivariable logistic regression were used.

Results: We included 14,778,506 older adults and 10.1% had ADRD. Those with ADRD were older (mean age [SE] = 83 [0.6] vs 75 [0.2] years; P < 0.001), had a higher proportion of Black (11.6% vs 6.3%) and Hispanic (5.7% vs 4.7%) race and ethnicity (P = 0.008), and had higher MTM eligibility (25.3% vs 14.8%; P < 0.001) compared with those without ADRD. Older adults with ADRD were more likely to be eligible for MTM (odds ratio [OR] = 1.95, 95% CI = 1.41-2.70) but not after adjusting for covariates (adjusted OR = 1.41, 95% CI = 0.88-2.27). Overall, 16.9% received a CMR. CMR receipt was lower in those with ADRD compared with those without (10.4% vs 18.2%), but not significantly different (P = 0.12). ADRD status was not associated with CMR receipt (OR = 0.52, 95% CI = 0.23-1.21, adjusted OR = 0.75, 95% CI = 0.25-2.29).

Conclusions: Older adults with ADRD were not more likely to be MTM eligible or receive a CMR compared with those without ADRD. Strategies to improve MTM program design are needed to increase CMR receipt among older adults with ADRD.

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来源期刊

Journal of managed care & specialty pharmacy Health Professions-Pharmacy

CiteScore

3.50

自引率

4.80%

发文量

131

期刊介绍： JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.