Papers by Benjamin F Banahan III
Current medical research and opinion, Jan 12, 2018
To develop a self-reported measure for medication adherence and compare its ability to predict th... more To develop a self-reported measure for medication adherence and compare its ability to predict the proportion of days covered (PDC) with contemporary scales. Retrospective prescription fill data from three community pharmacies in the Southeastern US were assessed to identify patients that were 18 years of age or older, and had received at least one medication for diabetes, hypertension, or dyslipidemia. A cross-sectional survey containing the Medication adherence Estimation and Differentiation Scale (MEDS) was administered among these pharmacy patrons. The MEDS assessed the extent and reasons for non-adherence. Survey responses were anonymously linked with retrospective prescription fill data. A total of 685 patients were sampled. The proportion of days covered (PDC) was used as the criterion measure. The Morisky, Green, and Levine Adherence Scale (1986 Morisky scale) and the Medication Adherence Reasons Scale (MAR-Scale) were used as comparators. The MEDS presented a five-factor so...
Assessment, 2018
The objective of this study was to develop a subtle self-report scale-the Subtle ADHD Malingering... more The objective of this study was to develop a subtle self-report scale-the Subtle ADHD Malingering Screener (SAMS)-to screen for malingering among individuals reporting symptoms of attention deficit/hyperactivity disorder (ADHD). This study employed a cross-sectional experimental design with an ADHD group, a control group-comprising individuals without ADHD-and a malingering group-comprising individuals without ADHD who were instructed to feign ADHD in their responses. Factor analysis and psychometric testing were conducted to develop a final scale that could distinguish the malingering from the other groups. A 10-item, two-factor solution was obtained for the SAMS, with a sensitivity of 90.3% and specificity of 80.1%. The SAMS presents an innovative approach to help reduce overdiagnosis of ADHD and misuse of prescription stimulants. The efficient, straightforward form of the measure particularly enhances its potential application in both medical and psychosocial clinical settings.
Journal of managed care & specialty pharmacy, 2016
In 2011, the U.S. Department of Health and Human Services sent a letter to state Medicaid directo... more In 2011, the U.S. Department of Health and Human Services sent a letter to state Medicaid directors explaining the need for oversight of psychiatric prescriptions for children with mental health disorders. The National Committee for Quality Alliance proposed 3 quality measures for rating managed care organizations (MCOs) that involve use of second-generation or atypical antipsychotics in children. In order to ensure appropriate use and to effectively manage the use of second-generation antipsychotics in children, MCOs need to better understand the factors that influence medication treatment decisions for children. To (a) determine how patient-level and physician-level factors influence decisions to prescribe second-generation antipsychotics to children (aged under 18 years) diagnosed with psychosis and (b) evaluate how the influence of these factors may differ between primary care providers and psychiatrists. This study employed a cross-sectional survey of 193 primary care providers...
Research in Social and Administrative Pharmacy, 2015
Although the literature has demonstrated positive patient outcomes from medication therapy manage... more Although the literature has demonstrated positive patient outcomes from medication therapy management (MTM), implementing it in community pharmacy continues to be met with significant barriers. To make MTM implementation more attainable, scalable, and sustainable in community pharmacies, this paper puts out a call for the need to identify the proportion of patients who clinically qualify for various levels of intensity of MTM services. This paper presents three proposed levels of MTM: adherence management (lowest level of MTM intensity), interventions on drug-related problems (mid-level MTM intensity), and disease state management (highest level of intensity). It is hypothesized that the lowest levels of MTM intensity would be sufficient to address medication problems in the vast majority of patients and require fewer MTM skills and resources, while the highest levels of MTM intensity (requiring the most skills and resources) would address medication problems in the smallest number of patients whose medication problems could not resolved with lower-intensity MTM. Future research in this area will involve testing previously designed instruments to determine why patients are not adhering to their medication regimen, following patients who have already had their adherence managed with medication synchronization, and tracking patients who will require higher levels of pharmacy services.
International journal of nursing studies, 2007
Non-adherence to medications is a prevalent and persistent healthcare problem, particularly for p... more Non-adherence to medications is a prevalent and persistent healthcare problem, particularly for patients with a chronic disorder. Researchers have endeavoured to address poor adherence for the past five decades resulting in the accumulation of a vast body of literature. Despite the enormity of research conducted, interventions to date have neither been cost-effective nor predictably clinically effective in enhancing medication adherence. Though concerning, such contemporary information serves to refocus attention on the adequacy of knowledge regarding the factors influencing medication non-adherence. Although little consensus exists regarding the optimal categorisation of these influencing factors, increasingly, the broad and 'all encompassing' categorisation of intentional and unintentional factors is being used to account for patient medication-taking behaviours and actions. An extensive review of the related literature provides the basis for a critical discussion on the v...
Value in Health, 2011
OBJECTIVES: Cardiovascular disease (CVD) remains the leading cause of death in the United State (... more OBJECTIVES: Cardiovascular disease (CVD) remains the leading cause of death in the United State (US). Both hyperlipidemia and hypertension are known risk factors for CVD. Tobacco use augments this risk by lowering the HDL cholesterol, increasing blood clotting, and acutely elevating blood pressure. The objective of this study was to examine predictors of having both co-morbidities including demographic characteristics and smoking status METHODS: A retrospective crosssectional study was conducted using the NHANES 2007-2008 database, a stratified multistage probability sample of the civilian non-institutionalized US population. The outcome variable was defined as being diagnosed with both hypertension and
Value in Health, 2009
To examine the relationship between payer status and potential confounders on DAMA using the Nati... more To examine the relationship between payer status and potential confounders on DAMA using the National Hospital Discharge Survey. METHODS: Retrospective analysis of a random, nationally representative sample of inpatient discharges in the US from 2004 to 2006. Patients represent discharges from shortstay non-institutional hospitals in the US. Newborns and patients with an undefi ned payer status were excluded. Only patients with a routine or DAMA discharge status were included. A logistic regression analysis was performed modeling DAMA versus routine discharge as the outcome variable, with payer status as the primary predictor, and confounder variables, including gender, race, marital status, hospital type, geographic region, admission type and source, and drug abuse/addiction. Logistic regression analysis was also performed after removing drug/alcohol abuse/addiction patients. RESULTS: From 2004 to 2006 DAMA accounted for 1.23% (n 946,232) of all hospital discharges when drug and alcohol abuse/addiction patients are included and 0.76% (n 510,556) when excluded. Controlling for the confounder variables, public (AOR 0.72, 95% CI 0.61-0.80) and privately (AOR 0.46, 95% CI 0.40-0.52) insured patients are signifi cantly less likely to DAMA than self-pay patients. Consistent with the literature, males, African-Americans, private hospitals, emergency admissions, and drug (AOR 4.57, 95% CI 4.22-4.96) and alcohol (AOR 5.00, 95% CI 4.46-5.61) abuse/addiction are signifi cant risk factors for DAMA. Many of these relationships become stronger when substance abuse cases are excluded. CONCLUSIONS: Considerable evidence exists that initiatives may be needed to better manage self-pay patients and ensure they do not DAMA. Further research should be done with longitudinal data to examine the relationship between DAMA and health outcomes. Prior research indicates that DAMA predictors may also be responsible for non-compliance of prescribed drug therapy, especially following discharge. Therefore the potential for early pharmacist involvement has also been identifi ed.
Value in Health, 2008
Little is known about the quality of drug administration and safety in German nursing homes. In 2... more Little is known about the quality of drug administration and safety in German nursing homes. In 2002 a group of health authority pharmacists in the federal state of North Rhine-Westphalia inspected the quality of drug supply in 120
Value in Health, 2008
Little is known about the quality of drug administration and safety in German nursing homes. In 2... more Little is known about the quality of drug administration and safety in German nursing homes. In 2002 a group of health authority pharmacists in the federal state of North Rhine-Westphalia inspected the quality of drug supply in 120
Social Science Computer Review, 1995
Health Marketing Quarterly, 1987
American Heart Journal, 2013
Randomized clinical trials comparing coronary artery bypass grafting (CABG) with percutaneous cor... more Randomized clinical trials comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) have largely excluded patients with chronic kidney disease (CKD), leading to uncertainty about the optimal coronary revascularization strategy. We sought to test the hypothesis that an initial strategy of CABG would be associated with lower risks of long-term mortality and cardiovascular morbidity compared with PCI for the treatment of multivessel coronary heart disease in the setting of CKD. We created a propensity score-matched cohort of patients aged ≥30 years with no prior dialysis or renal transplant who received multivessel coronary revascularization between 1996 and 2008 within a large integrated health care delivery system in northern California. We used extended Cox regression to examine death from any cause, acute coronary syndrome, and repeat revascularization. Coronary artery bypass grafting was associated with a significantly lower adjusted rate of death than PCI across all strata of estimated glomerular filtration rate (eGFR) (in mL/min per 1.73 m(2)): the adjusted hazard ratio (HR) was 0.81, 95% CI 0.68 to 1.00 for patients with eGFR ≥60; HR 0.73 (CI 0.56-0.95) for eGFR of 45 to 59; and HR 0.87 (CI 0.67-1.14) for eGFR <45. Coronary artery bypass grafting was also associated with significantly lower rates of acute coronary syndrome and repeat revascularization at all levels of eGFR compared with PCI. Among adults with and without CKD, multivessel CABG was associated with lower risks of death and coronary events compared with multivessel PCI.
OBJECTIVES: Gastro esophageal reflux disease (GERD) is commonly associated with a significant adv... more OBJECTIVES: Gastro esophageal reflux disease (GERD) is commonly associated with a significant adverse impact on the patient's quality of life, his/her employment record, and healthcare systems. The aim of this analysis was to conduct a pooled analysis of the data from five European studies (GERD Management Project) to assess the potential benefit for healthcare providers of a structured treatment pathway (STP) for the treatment of GERD. METHODS: We conducted a meta-analysis of five cluster randomised clinical trials comparing a new management strategy with usual care in patients with GERD conducted in Austria, Italy, Norway, Spain and Sweden (NCT00842387). The educational intervention on investigators was based on the GerdQ questionnaire to stratify adult patients with classical symptoms of GERD according to the frequency and impact of symptoms. The most effective acid-suppressive therapy (esomeprazole 40 mg once daily) was proposed to be used only in patients with the highest GerdQ symptom impact score (Ն3 of a possible 6). Calculations were performed using data on mean values for resource utilization (including emergency room visits, hospitalization, primary-care physician visits, specialist visits and endoscopies) multiplied by the unit cost of each variable. UK unit costs were applied to the entire European cohort. RESULTS: 1947 patients were included in the analysis, 944 (49%) on the STP group and 1003 (51%) on the usual clinical practice (UCP) group. In the STP group, GerdQ scores improved significantly more during therapy than in the UCP group. Patients in the STP group had lower overall healthcare costs, 107.59€ per patient/year, than those in the UCP group, 137.55€ per patient/year (i.e. 22% reduction in healthcare utilization costs). CONCLUSIONS: The implementation of a structured treatment pathway for the treatment of GERD based in the GerdQ questionnaire could considerably reduce the disease healthcare utilization costs compared with the usual clinical practice.
Uploads
Papers by Benjamin F Banahan III