Patients with diabetes who use mail order pharmacy are less likely to visit ERs

November 22, 2013

OAKLAND, Calif. -- Patients with diabetes who received prescribed heart medications by mail were less likely to visit the emergency room than those patients who picked up prescriptions in person, according to a new Kaiser Permanente study published in the American Journal of Managed Care.

The study examined 17,217 adult Kaiser Permanente members with diabetes who were first prescribed heart medications in 2006 and followed them for 3 years. It found that diabetes patients under age 65 who used mail order pharmacy had significantly fewer emergency room visits for any cause than those who picked up prescriptions (33.8 percent vs. 40.2 percent, respectively).

This study is the first to examine the potential impacts of mail order pharmacy on patient safety and utilization, and explores the concern of patients experiencing adverse outcomes because they do not meet face-to-face with a pharmacist.

"Overall, we didn't see any safety concerns," said Julie A. Schmittdiel, PhD, research scientist with the Kaiser Permanente Division of Research and the study's lead author. "For the vast majority of people, mail order pharmacy works well."

Kaiser Permanente offers members the options of using its mail order pharmacy or picking up prescriptions at walk-in pharmacies located in Kaiser Permanente hospitals and outpatient medical buildings. Medications can be delivered by mail with free shipping; mail order requests can be made by phone or online; and mail order copayments are often lower for the same supply as walk-in pharmacies.

The study did not look at possible reasons why the use of mail order pharmacies was associated with fewer emergency room visits, but researchers noted that further investigation may involve exploring factors such as patients having disabilities, time constraints or limited transportation.

This study is part of Kaiser Permanente's ongoing efforts to understand how mail order pharmacies can improve care. Schmittdiel's previous studies have shown that patients who use mail order pharmacy have significantly better medication adherence and cholesterol management.
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Kaiser Permanente can conduct transformational health research in part because it has the largest private patient-centered electronic health system in the world. The organization's electronic health record system, Kaiser Permanente HealthConnect®, securely connects 9.1 million patients to 16,000 physicians in almost 600 medical offices and 37 hospitals. It also connects Kaiser Permanente's research scientists to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.

In addition to Schmittdiel, co-authors of the study were Andrew J. Karter, PhD, and Wendy Dyer, MS, Kaiser Permanente Division of Research; James Chan, PharmD, PhD, Pharmacy Outcomes Research Group, Kaiser Permanente Northern California; and O. Kenrik Duru, MD, MSHS, David Geffen School of Medicine, University of California, Los Angeles.

The study was funded by the Centers for Disease Control and Prevention, Division of Diabetes Translation.

About the Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR's 550-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us @KPDOR.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 9.1 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

For more information, contact:

Cyrus Hedayati
chedayati@golinharris.com
415-318-4377

Janet Byron
janet.l.byron@kp.org
510-891-3115

Kaiser Permanente

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