Evaluation of a self-management implementation intervention to improve hypertension control among patients in Medicaid.
Elevated blood pressure can lead to serious patient morbidity and mortality. The aim of the study was to evaluate the implementation of a tailored multifaceted program, administered by care managers in a Medicaid setting to improve hypertension medication adherence. The program enrolled 558 Medicaid patients. Patients had at least one phone call by care managers. The individually tailored program focused on improving lifestyle and medication adherence. The primary outcome was the medication possession ratio (MPR), calculated using fill history from pharmacy claims. We observed an improvement of medication possession from 55% 9-12 months prior to program enrollment to 77% 9-12 months post initiation of the program. We demonstrated 12 month sustainability and increased MPR. Personal interaction by phone allows the intervention to be tailored to participants' current concerns, health goals, and specific barriers to achieving these goals.
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC USA ; Department of Medicine, Division of General Internal Medicine, Duke University, 2424 Erwin Road, Hock Plaza, Durham, NC 27703 USA ; Department of Psychiatry and Behavioral Sciences, School of Nursing, & Center for Aging and Human Development, Duke University, Durham, NC USA.
Hayden B
HB
Bosworth
C Annette
CA
Dubard
Jill
J
Ruppenkamp
Troy
T
Trygstad
Denis Levis
DL
Hewson
George L
GL
Jackson
Health care disparities; Hypertension; Medicaid; Medication adherence