title: Pilot assessment of patient satisfaction and clinical impact of Medicare Part D in diabetic geriatric patients.
abstract: OBJECTIVE
  To assess patients' 1) satisfaction with their decision to enroll or not enroll in the Medicare Part D program, and 2) clinical status of diabetes before and after decision to enroll in Medicare Part D.
  
  
  METHODS
  Patients 65 years or older were enrolled in the study from November 2006 through February 2007. Patients were screened by a clinical pharmacist at their clinician visit and administered a Medicare Part D satisfaction survey. Upon completion of the survey, a retrospective chart review was completed in diabetic patients who were enrolled in Medicare Part D to assess goal attainment of glycosylated hemoglobin (HbA1c), low-density lipoprotein (LDL) and blood pressure. Pre-enrollment values were obtained in the 6 months prior to the start of Medicare Part D enrollment (July 1- December 31, 2005). Post- enrollment values were obtained after enrollment was complete for the 2006 year (May 1- October 31, 2006).
  
  
  RESULTS
  Results show that 74% (60/81) of patients surveyed were enrolled into the Medicare Part D program, including patients who have dual eligibility. Of the 60 patients who were enrolled in Medicare Part D, 48 patients (80.0%) responded that they were satisfied with their decision to enroll. Clinical outcomes were unchanged from the pre-enrollment to the post-enrollment periods. Mean HbA1c was 7.47% in the pre-enrollment period and 7.25% post- enrollment (differencepre-post = 0.23; 95%CI = -0.28 to 0.73). There was no change in LDL in the two time periods (pre = 79.4 mg/dL; post = 79.7; differencepre-post = -0.25; 95%CI = -13.6 to 13.1). Similarly, there were no significant differences observed for blood pressure. Mean systolic blood pressure was 129.5 in the pre-enrollment period and 131.6 in the post-enrollment period (differencepre-post = -2.1; 95%CI = -7.0 to 2.7). Mean diastolic blood pressure was 70.3 for the pre- enrollment period and 70.7 for the post-enrollment period (differencepre-post = -0.4; 95%CI = -4.2 to 3.4).
  
  
  CONCLUSIONS
  Patients were generally satisfied with their decision to enroll in Medicare Part D. Clinical outcomes were not affected by participation in a Medicare Part D plan. More longitudinal studies are necessary to determine long term impact of Medicare Part D on diabetes management.
authors.affiliation: College of Pharmacy, University of Illinois at Chicago . Chicago, IL ( USA ).
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Kim
authors.affiliation: College of Pharmacy, University of Illinois at Chicago . Chicago, IL ( USA ).
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Touchette
authors.affiliation: Manager, Research and Public Policy, Ambulatory Care Pharmacy Department. Clinical Assistant Professor. Department of Pharmacy Practice. Center for Pharmacoeconomic Research. College of Pharmacy, University of Illinois at Chicago . Chicago, IL ( USA ).
authors.forename: Jo A
authors.initials: JA
authors.lastname: Stubbings
authors.affiliation: Clinical Education Coordinator and Assistant Professor. College of Pharmacy, University of Minnesota . Heart & Vascular Clinical Specialist, Park Nicollet Methodist Hospital. Minneapolis, MN ( USA ).
authors.forename: Anne M
authors.initials: AM
authors.lastname: Schullo-Feulner
authors.affiliation: Professor. School of Pharmacy, University of Pittsburgh , Pittsburgh, PA ( USA ).
authors.forename: Karen S
authors.initials: KS
authors.lastname: Pater
keywords: Aged; Diabetes Mellitus; Medicare Part D; United States