A practical physician's guide to the Medicare drug benefit plan
ABSTRACT Recent commentaries on Medicare Part D highlight both the early failings and the successes of the program. However, regardless of one's opinions about the program, Part D is a reality that millions of Medicare beneficiaries must address now and in the future. The ultimate economic, policy, and clinical success of the Medicare drug benefit plan depends on its transparency and ability to be navigated together by patients, physicians, and other parties. Although Medicare Part D is likely to evolve considerably in the future, it will continue to present elderly adults with numerous plan options and rules and therefore present persistent challenges for patients and physicians. By focusing on a few crucial aspects of Part D and taking advantage of available resources, physicians can simplify Part D for their patients, help them make informed decisions about enrollment and plan selection, and possibly help them save money with their current PDP. This may, in turn, reduce beneficiaries' out-of-pocket prescription costs, thereby improving patients' access to medications and possibly their medication adherence and health outcomes as well.
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ABSTRACT: Optimizing medication adherence is a significant challenge for clinicians caring for older adults, particularly those with multiple chronic health conditions. Nearly half of all adults aged 65 or older take five or more medications regularly; however, adherence to chronic pharmacological therapies is often poor . Overall, 40% of older Medicare beneficiaries reported one or more forms of medication non-adherence in the previous year . Older patients are often more susceptible to the outcomes of poor adherence including worsening symptoms of disease and disease severity, increased hospital admissions, costs, and mortality [2, 3]. Older adults face many of the barriers to adherence discussed in previous chapters; however, age-related physical or cognitive impairments, multiple chronic health conditions, and/or complex treatment regimens frequently create distinct challenges related to adherence in this population. The aims of this chapter are to discuss special considerations related to medication adherence in older adults and to offer practical advice for improving medication adherence in this population.
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