The Foundation's initiative, Finding Answers: Disparities Research for Change, was designed to use research and evaluation to test hypothetical solutions for reducing racial and ethnic disparities in health care settings and actual disparity reduction outcomes in ongoing programs.Medication adherence is suboptimal among diabetic patients particularly those who belong to vulnerable populations. The objective of this project is to evaluate if the implementation of an innovative point of care medication delivery system in a network of South Florida clinics located in 4 healthcare shortage areas can improve medication adherence and clinical outcomes among diabetic Medicare beneficiaries and to explore if racial/ethnic disparities are reduced. To fulfill these objectives, the project team will perform a pre-post experimental design of all diabetic subjects who take oral anti-diabetic medications and who have been enrolled in the practice for 12 months before and 12 months after the intervention. The data will be extracted retrospectively from the electronic medical record. The outcomes of interest will be Medication possession ratio, HbA1c, LDL and blood pressure.Linear mixed regression models will be performed to compare the pre and post intervention periods. A survey will also be performed to capture the race/ethnicity of the participants and to study the impact of the intervention on usual barriers to adherence from the perspective of the patients. In addition, a qualitative study will be conducted using a key informant interview format to interview all stakeholders and explore in depth the perceived impact of the intervention, barriers and facilitators of the implementation process and tips/advice for future implementation.The results will be disseminated through the production of a video that will depict how the POCMDS works and will highlight the main results from the case study. This video along with a detailed "How to manual " will be posted on the RWJF Web site and possibly others. The dissemination will target policy makers as well as the CEOs of other medical practices. The researchers will also produce manuscripts for peer-reviewed journals to disseminate the findings among other investigators.
Amount Awarded $399,698.00
Awarded on: 11/17/2010
Time frame: 12/15/2010 - 12/14/2012
Grant Number: 68499