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Medication adherence usually refers to whether patients take their medications as prescribed (eg, twice daily), as well as whether they continue to take a prescribed medication. Medication nonadherence is a growing concern to clinicians, healthcare systems, and other stakeholders (eg, payers) because of mounting evidence that it is prevalent and associated(More)
OBJECTIVE Our aim was to measure the prevalence and time trends of diabetes, impaired fasting glucose, and insulin resistance in the United States during the periods 1988-1994 and 1999-2002. MATERIALS AND METHODS Data were derived from two nationally representative samples of the adult U.S. population collected as part of the National Health and Nutrition(More)
BACKGROUND The Veterans Health Administration (VHA) is the largest integrated US health system to implement the patient-centered medical home. The Patient Aligned Care Team (PACT) initiative (implemented 2010-2014) aims to achieve team based care, improved access, and care management for more than 5 million primary care patients nationwide. OBJECTIVES To(More)
OBJECTIVE To examine the impact of a medication copayment increase on adherence to diabetes, hypertension, and hyperlipidemic medications. STUDY DESIGN Retrospective pre-post observational study. METHODS This study compared medication adherence at 4 Veterans Affairs medical centers between veterans who were exempt from copayments and propensity-matched(More)
OBJECTIVES Our aim was to investigate the relation between fish consumption and incidence of congestive heart failure (CHF). BACKGROUND The incidence and health burden of CHF are rising, particularly in older persons. Although n-3 fatty acids have effects that could favorably influence risk of CHF, the relation between fish intake and CHF incidence is(More)
IMPORTANCE Adherence to cardioprotective medication regimens in the year after hospitalization for acute coronary syndrome (ACS) is poor. OBJECTIVE To test a multifaceted intervention to improve adherence to cardiac medications. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, 253 patients from 4 Department of Veterans Affairs(More)
Observational studies of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD) have shown improved survival whereas randomized trials have not. It has been suggested that this difference may be due to immortal time bias. To investigate this further, we performed a prospective cohort study of patients with COPD, using time-dependent methods(More)
OBJECTIVES To evaluate the association between alcohol screening results and health status or mortality in elderly patients. DESIGN Cross-sectional and longitudinal cohort studies. SETTING Primary care clinics at seven Veterans Affairs medical centers. PARTICIPANTS A total of 16,958 male patients aged 65 and older. MEASUREMENTS Alcohol screening(More)
BACKGROUND It is unknown whether the appropriate use of percutaneous coronary intervention (PCI) has improved over time and whether trends in PCI appropriateness have been accompanied by changes in the use of PCI. METHODS AND RESULTS We applied appropriate use criteria to determine the appropriateness of all 51 872 PCI performed in Washington State from(More)
PURPOSE We investigated whether iron deficiency, with or without anemia, is associated with an increased likelihood of gastrointestinal malignancy. SUBJECTS AND METHODS Data were obtained from the first National Health and Nutrition Examination Survey and Epidemiologic Followup Study, a nationally representative, prospective cohort study that measured(More)