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Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014

INTRODUCTION: In 2010, national guidelines recommended that women with nonmetastatic, hormone receptor–positive breast cancer take adjuvant hormone therapy for 5 years. As results from randomized clinical trials became available, guidelines were revised in 2014 to recommend 10 years of therapy. Desp...

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Autores principales: Wagner, Victoria L., Jing, Wei, Boscoe, Francis P., Schymura, Maria J., Roohan, Patrick J., Gesten, Foster C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008863/
https://www.ncbi.nlm.nih.gov/pubmed/27584876
http://dx.doi.org/10.5888/pcd13.160185
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author Wagner, Victoria L.
Jing, Wei
Boscoe, Francis P.
Schymura, Maria J.
Roohan, Patrick J.
Gesten, Foster C.
author_facet Wagner, Victoria L.
Jing, Wei
Boscoe, Francis P.
Schymura, Maria J.
Roohan, Patrick J.
Gesten, Foster C.
author_sort Wagner, Victoria L.
collection PubMed
description INTRODUCTION: In 2010, national guidelines recommended that women with nonmetastatic, hormone receptor–positive breast cancer take adjuvant hormone therapy for 5 years. As results from randomized clinical trials became available, guidelines were revised in 2014 to recommend 10 years of therapy. Despite evidence of its efficacy, low initiation rates have been documented among women insured by New York State Medicaid. This article describes a coordinated quality improvement pilot conducted by a state department of health and Medicaid managed care plans to engage women in guideline-concordant adjuvant hormone therapy. METHODS: Women enrolled in Medicaid managed care with nonmetastatic, hormone receptor–positive breast cancer and who had surgery from May 1, 2012, through November 30, 2012, were identified using linked Medicaid and Cancer Registry data. Adjuvant hormone therapy status was determined from Medicaid pharmacy data. Contact information for nonadherent women was supplied to health plan care managers who conducted outreach activities. Adjuvant hormone therapy status in the 6 months following outreach was evaluated. RESULTS: In the 6 months postoutreach, 61% of women in the contacted group filled at least 1 prescription, compared with 52% in the noncontacted group. Among those with at least 1 filled prescription, 50% of the contacted group were adherent, compared with 25% in the noncontacted group. CONCLUSION: This pilot suggests outreach conducted by health plan care managers, facilitated by linked Medicaid and Cancer Registry data, is an effective method to improve adjuvant hormone therapy initiation and adherence rates in Medicaid managed care–insured women.
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spelling pubmed-50088632016-09-14 Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014 Wagner, Victoria L. Jing, Wei Boscoe, Francis P. Schymura, Maria J. Roohan, Patrick J. Gesten, Foster C. Prev Chronic Dis Original Research INTRODUCTION: In 2010, national guidelines recommended that women with nonmetastatic, hormone receptor–positive breast cancer take adjuvant hormone therapy for 5 years. As results from randomized clinical trials became available, guidelines were revised in 2014 to recommend 10 years of therapy. Despite evidence of its efficacy, low initiation rates have been documented among women insured by New York State Medicaid. This article describes a coordinated quality improvement pilot conducted by a state department of health and Medicaid managed care plans to engage women in guideline-concordant adjuvant hormone therapy. METHODS: Women enrolled in Medicaid managed care with nonmetastatic, hormone receptor–positive breast cancer and who had surgery from May 1, 2012, through November 30, 2012, were identified using linked Medicaid and Cancer Registry data. Adjuvant hormone therapy status was determined from Medicaid pharmacy data. Contact information for nonadherent women was supplied to health plan care managers who conducted outreach activities. Adjuvant hormone therapy status in the 6 months following outreach was evaluated. RESULTS: In the 6 months postoutreach, 61% of women in the contacted group filled at least 1 prescription, compared with 52% in the noncontacted group. Among those with at least 1 filled prescription, 50% of the contacted group were adherent, compared with 25% in the noncontacted group. CONCLUSION: This pilot suggests outreach conducted by health plan care managers, facilitated by linked Medicaid and Cancer Registry data, is an effective method to improve adjuvant hormone therapy initiation and adherence rates in Medicaid managed care–insured women. Centers for Disease Control and Prevention 2016-09-01 /pmc/articles/PMC5008863/ /pubmed/27584876 http://dx.doi.org/10.5888/pcd13.160185 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Original Research
Wagner, Victoria L.
Jing, Wei
Boscoe, Francis P.
Schymura, Maria J.
Roohan, Patrick J.
Gesten, Foster C.
Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title_full Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title_fullStr Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title_full_unstemmed Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title_short Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care–Insured Women, New York State, 2012–2014
title_sort improving adjuvant hormone therapy use in medicaid managed care–insured women, new york state, 2012–2014
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008863/
https://www.ncbi.nlm.nih.gov/pubmed/27584876
http://dx.doi.org/10.5888/pcd13.160185
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