scholarly journals PHP63 SEGMENTED REGRESSION ANALYSIS OF INTERRUPTED TIME SERIES PRESCRIPTION GROSS MARGIN TRENDS FOR INDEPENDENT PHARMACIES BEFORE AND AFTER MEDICARE PART D

2008 ◽  
Vol 11 (3) ◽  
pp. A48
Author(s):  
KM Richards ◽  
MD Shepherd
Keyword(s):  
Time Series ◽  
Regression Analysis ◽  
Interrupted Time Series ◽  
Medicare Part D ◽  
Medicare Part ◽  
Segmented Regression ◽  
Gross Margin ◽  
Part D ◽  
Segmented Regression Analysis ◽  
Before And After

scholarly journals Impact of Medicare prescription drug (Part D) coverage expansion on utilisation and financial burden of benzodiazepines among older adults: an interrupted time series analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053717
Author(s):  
Minghui Li ◽  
Jing Yuan ◽  
Chelsea Dezfuli ◽  
Z Kevin Lu
Keyword(s):  
Older Adults ◽  
Time Series ◽  
Financial Burden ◽  
Alternative Therapy ◽  
Interrupted Time Series ◽  
Medicare Part D ◽  
Annual Rate ◽  
Medicare Part ◽  
Part D ◽  
Coverage Expansion

ObjectiveBenzodiazepines were excluded from Medicare Part D coverage since its introduction in 2006. Part D expanded coverage for benzodiazepines in 2013. The objective was to examine the impact of Medicare Part D coverage expansion on the utilisation and financial burden of benzodiazepines in older adults.DesignInterrupted time series with a control group.SettingNationally representative sample.Participants53 150 468 users of benzodiazepines and 21 749 749 users of non-benzodiazepines (an alternative therapy) from the Medicare Current Beneficiary Survey between the pre-expansion (2006–2012) and post-expansion (2013–2017) periods.InterventionMedicare Part D coverage expansion on benzodiazepines.Primary and secondary outcome measuresAnnual rate of benzodiazepines and non-benzodiazepines, average number of benzodiazepines and non-benzodiazepines and average cost of benzodiazepines and non-benzodiazepines.ResultsAfter Medicare Part D coverage expansion, the level of the annual rate of benzodiazepines increased by 8.20% (95% CI: 6.07% to 10.32%) and the trend decreased by 1.03% each year (95% CI: −1.77% to −0.29%). The trend of the annual rate of non-benzodiazepines decreased by 0.72% each year (95% CI: −1.11% to −0.33%). For the average number of benzodiazepines, the level increased by 0.67 (95% CI: 0.52 to 0.82) and the trend decreased by 0.10 each year (95% CI: −0.15 to –0.05). For the average number of non-benzodiazepines, the level decreased by 0.11 (95% CI: −0.21 to –0.01) and the trend decreased by 0.04 each year (95% CI: −0.08 to –0.01). No significant level and trend changes were identified for the average cost of benzodiazepines and non-benzodiazepines.ConclusionsAfter Medicare Part D coverage expansion, there was a sudden increase in the utilisation of benzodiazepines and a decreasing trend in the long-term. The increase in the utilisation of benzodiazepines did not add a financial burden to older adults. As an alternative therapy, the utilisation of non-benzodiazepines decreased following the coverage expansion.

scholarly journals Educational intervention to optimise serum immunoglobulin test use in Irish primary care: an interrupted time series with segmented regression analysis

2019 ◽  
Vol 70 (691) ◽  
pp. e146-e154
Author(s):  
Sharon L Cadogan ◽  
John P Browne ◽  
Colin P Bradley ◽  
Anthony P Fitzgerald ◽  
Mary R Cahill
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Regression Analysis ◽  
Laboratory Data ◽  
Interrupted Time Series ◽  
Serum Immunoglobulin ◽  
Segmented Regression ◽  
Segmented Regression Analysis ◽  
The Impact ◽  
Test Ordering

BackgroundImplementation science experts recommend that theory-based strategies, developed in collaboration with healthcare professionals, have greater chance of success.AimThis study evaluated the impact of a theory-based strategy for optimising the use of serum immunoglobulin testing in primary care.Design and settingAn interrupted time series with segmented regression analysis in the Cork–Kerry region, Ireland. An intervention was devised comprising a guideline and educational messages-based strategy targeting previously identified GP concerns relevant to testing for serum immunoglobulins.MethodInterrupted time series with segmented regression analysis was conducted to evaluate the intervention, using routine laboratory data from January 2012 to October 2016. Data were organised into fortnightly segments (96 time points pre-intervention and 26 post-intervention) and analysed using incidence rate ratios with their corresponding 95% confidence intervals.ResultsIn the most parsimonious model, the change in trend before and after the introduction of the intervention was statistically significant. In the 1-year period following the implementation of the strategy, test orders were falling at a rate of 0.42% per fortnight (P<0.001), with an absolute reduction of 0.59% per fortnight, corresponding to a reduction of 14.5% over the 12-month study period.ConclusionThe authors’ tailored guideline combined with educational messages reduced serum immunoglobulin test ordering in primary care over a 1-year period. Given the rarity of the conditions for which the test is utilised and the fact that the researchers had only population-level data, further investigation is required to examine the clinical implications of this change in test-ordering patterns.

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