CVS Health

About: CVS Health is a based out in . It is known for research contribution in the topics: Health care & Population. The organization has 100 authors who have published 116 publications receiving 1439 citations. The organization is also known as: CVS Caremark & CVS Health (United States).

Patients’ Satisfaction with and Preference for Telehealth Visits

Abstract: Background One-quarter of U.S. patients do not have a primary care provider or do not have complete access to one. Work and personal responsibilities also compete with finding convenient, accessible care. Telehealth services facilitate patients’ access to care, but whether patients are satisfied with telehealth is unclear.

Effect of Reminder Devices on Medication Adherence: The REMIND Randomized Clinical Trial.

Abstract: Importance Forgetfulness is a major contributor to nonadherence to chronic disease medications and could be addressed with medication reminder devices. Objective To compare the effect of 3 low-cost reminder devices on medication adherence. Design, Setting, and Participants This 4-arm, block-randomized clinical trial involved 53 480 enrollees of CVS Caremark, a pharmacy benefit manager, across the United States. Eligible participants were aged 18 to 64 years and taking 1 to 3 oral medications for long-term use. Participants had to be suboptimally adherent to all of their prescribed therapies (with a medication possession ratio of 30% to 80%) in the 12 months before randomization. Participants were stratified on the basis of the medications they were using at randomization: medications for cardiovascular or other nondepression chronic conditions (the chronic disease stratum) and antidepressants (the antidepressant stratum). In each stratum, randomization occurred within blocks defined by whether all of the patient’s targeted medications were dosed once daily. Patients were randomized to receive in the mail a pill bottle strip with toggles, digital timer cap, or standard pillbox. The control group received neither notification nor a device. Data were collected from February 12, 2013, through March 21, 2015, and data analyses were on the intention-to-treat population. Main Outcomes and Measures The primary outcome was optimal adherence (medication possession ratio ≥80%) to all eligible medications among patients in the chronic disease stratum during 12 months of follow-up, ascertained using pharmacy claims data. Secondary outcomes included optimal adherence to cardiovascular medications among patients in the chronic disease stratum as well as optimal adherence to antidepressants. Results Of the 53 480 participants, mean (SD) age was 45 (12) years and 56% were female. In the primary analysis, 15.5% of patients in the chronic disease stratum assigned to the standard pillbox, 15.1% assigned to the digital timer cap, 16.3% assigned to the pill bottle strip with toggles, and 15.1% assigned to the control arm were optimally adherent to their prescribed treatments during follow-up. There was no statistically significant difference in the odds of optimal adherence between the control and any of the devices (standard pillbox: odds ratio [OR], 1.03 [95% CI, 0.95-1.13]; digital timer cap: OR, 1.00 [95% CI, 0.92-1.09]; and pill bottle strip with toggles: OR, 0.94 [95% CI, 0.85-1.04]). In direct comparisons, the odds of optimal adherence were higher with a standard pillbox than with the pill bottle strip (OR, 1.10 [95% CI, 1.00-1.21]). Secondary analyses yielded similar results. Conclusions and Relevance Low-cost reminder devices did not improve adherence among nonadherent patients who were taking up to 3 medications to treat common chronic conditions. The devices may have been more effective if coupled with interventions to ensure consistent use or if targeted to individuals with an even higher risk of nonadherence. Trial Registration clinicaltrials.gov Identifier:NCT02015806

Twenty Years of Confusion in Human Evaluation : NLG Needs Evaluation Sheets and Standardised Definitions

Abstract: Human assessment remains the most trusted form of evaluation in NLG, but highly diverse approaches and a proliferation of different quality criteria used by researchers make it difficult to compare results and draw conclusions across papers, with adverse implications for meta-evaluation and reproducibility. In this paper, we present (i) our dataset of 165 NLG papers with human evaluations, (ii) the annotation scheme we developed to label the papers for different aspects of evaluations, (iii) quantitative analyses of the annotations, and (iv) a set of recommendations for improving standards in evaluation reporting. We use the annotations as a basis for examining information included in evaluation reports, and levels of consistency in approaches, experimental design and terminology, focusing in particular on the 200+ different terms that have been used for evaluated aspects of quality. We conclude that due to a pervasive lack of clarity in reports and extreme diversity in approaches, human evaluation in NLG presents as extremely confused in 2020, and that the field is in urgent need of standard methods and terminology.

Initial Choice of Oral Glucose-Lowering Medication for Diabetes Mellitus: A Patient-Centered Comparative Effectiveness Study

Abstract: Importance Although many classes of oral glucose-lowering medications have been approved for use, little comparative effectiveness evidence exists to guide initial selection of therapy for diabetes mellitus. Objective To determine the effect of initial oral glucose-lowering agent class on subsequent need for treatment intensification and 4 short-term adverse clinical events. Design, Setting, and Participants This study was a retrospective cohort study of patients who were fully insured members of Aetna (a large national health insurer) who had been prescribed an oral glucose-lowering medication from July 1, 2009, through June 30, 2013. Individuals newly prescribed an oral glucose-lowering agent who filled a second prescription for a medication in the same class and with a dosage at or above the World Health Organization’s defined daily dose within 90 days of the end-of-day’s supply of the first prescription were studied. Individuals with interim prescriptions for other oral glucose-lowering medications were excluded. Exposures Initiation of treatment with metformin, a sulfonylurea, a thiazolidinedione, or a dipeptidyl peptidase 4 inhibitor. Main Outcomes and Measures Time to addition of a second oral agent or insulin, each component separately, hypoglycemia, other diabetes-related emergency department visits, and cardiovascular events. Results A total of 15 516 patients met the inclusion criteria, of whom 8964 (57.8%) started therapy with metformin. In unadjusted analyses, use of medications other than metformin was significantly associated with an increased risk of adding a second oral agent only, insulin only, and a second agent or insulin ( P Conclusions and Relevance Despite guidelines, only 57.8% of individuals began diabetes treatment with metformin. Beginning treatment with metformin was associated with reduced subsequent treatment intensification, without differences in rates of hypoglycemia or other adverse clinical events. These findings have significant implications for quality of life and medication costs.