Serving underserved transplant recipients

Experience of the Medication Access Program

Christina Spivey, Marie Chisholm-Burns, Charlene Garrett, Kenneth M. Duke

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Programs have been established to help underserved, solid-organ transplant recipients and other patient populations address the burden of medication regimen costs. The purpose of this study was to describe one such program, the Medication Access Program (MAP), and the population of solid-organ transplant recipients it serves. An additional objective was to compare characteristics of recipients whose MAP enrollment was continued versus those who were discontinued during the annual re-enrollment period. Methods: Enrollment into MAP is based on referral from a pharmacist or another health care professional/transplant team member. To enroll, a recipient must complete an application which includes information about demographics, health care coverage, income, and medication regimen. To maintain enrollment, patients must complete a renewal application on an annual basis. Data were collected from renewal applications for 2012 and 2011 (for those who did not return the 2012 renewal applications). Chi-square analyses and Student's t-test for independent samples were conducted to compare the characteristics of those who renewed their MAP enrollment in 2012 and those who were discontinued because they did not return the renewal application. Multivariate stepwise logistic regression was conducted to determine variables predictive of MAP continuation status. Results: In total, 246 recipients were included. The majority qualified for Medicare (67.9%), did not qualify for Medicaid (69.9%), and did not have private health care coverage (63.8%). Significantly more continued recipients qualified for Medicare compared to discontinued recipients (P=0.002). Discontinued recipients had a greater number of past discontinuations than continued recipients (P=0.01). In the logistic regression analysis, qualifying for Medicare was significantly associated with continuation status (P=0.001). Conclusion: MAP is designed to increase medication access for low-income solid-organ transplant recipients through enrollment into medication assistance programs, education regarding medication therapy, and availability of medication assistance programs. Health care providers should use historical monitoring to identify high risk patients and implement programs that will facilitate continuity of care.

Original languageEnglish (US)
Pages (from-to)613-619
Number of pages7
JournalPatient Preference and Adherence
Volume8
DOIs
StatePublished - May 2 2014

Fingerprint

medication
recipient
Medicare
Transplants
Delivery of Health Care
experience
Logistic Models
organ transplant
Continuity of Patient Care
Population Control
Medicaid
Pharmacists
Health Personnel
health care
Referral and Consultation
Regression Analysis
Demography
Students
Education
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

Cite this

Serving underserved transplant recipients : Experience of the Medication Access Program. / Spivey, Christina; Chisholm-Burns, Marie; Garrett, Charlene; Duke, Kenneth M.

In: Patient Preference and Adherence, Vol. 8, 02.05.2014, p. 613-619.

Research output: Contribution to journalArticle

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abstract = "Objective: Programs have been established to help underserved, solid-organ transplant recipients and other patient populations address the burden of medication regimen costs. The purpose of this study was to describe one such program, the Medication Access Program (MAP), and the population of solid-organ transplant recipients it serves. An additional objective was to compare characteristics of recipients whose MAP enrollment was continued versus those who were discontinued during the annual re-enrollment period. Methods: Enrollment into MAP is based on referral from a pharmacist or another health care professional/transplant team member. To enroll, a recipient must complete an application which includes information about demographics, health care coverage, income, and medication regimen. To maintain enrollment, patients must complete a renewal application on an annual basis. Data were collected from renewal applications for 2012 and 2011 (for those who did not return the 2012 renewal applications). Chi-square analyses and Student's t-test for independent samples were conducted to compare the characteristics of those who renewed their MAP enrollment in 2012 and those who were discontinued because they did not return the renewal application. Multivariate stepwise logistic regression was conducted to determine variables predictive of MAP continuation status. Results: In total, 246 recipients were included. The majority qualified for Medicare (67.9{\%}), did not qualify for Medicaid (69.9{\%}), and did not have private health care coverage (63.8{\%}). Significantly more continued recipients qualified for Medicare compared to discontinued recipients (P=0.002). Discontinued recipients had a greater number of past discontinuations than continued recipients (P=0.01). In the logistic regression analysis, qualifying for Medicare was significantly associated with continuation status (P=0.001). Conclusion: MAP is designed to increase medication access for low-income solid-organ transplant recipients through enrollment into medication assistance programs, education regarding medication therapy, and availability of medication assistance programs. Health care providers should use historical monitoring to identify high risk patients and implement programs that will facilitate continuity of care.",
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