Satya Surbhi, PhD, assistant professor of Medicine in the Center for Health System Improvement at the University of Tennessee Health Science Center (UTHSC), received a $100,000 grant from the Pharmaceutical Research and Manufacturers of America Foundation to pursue research in improving medication adherence for low-income Tennessee Medicaid users.
Dr. Surbhi’s study showed that only 20 percent of Medicaid super-utilizers (patients with numerous hospital visits causing high health care costs) properly used their chronic disease medication as prescribed in a six-month period following a hospital discharge. Beneficiaries suffered from persistent ailments, such as diabetes, hypertension, congestive heart failure, coronary artery disease, and chronic lung diseases. Study participants noted that transportation barriers and financial burdens were the major factors making it difficult to get medicine in a timely manner. Dr. Surbhi contends that hospitals and payers can take steps to make medicine more accessible, which would then provide better health treatments for low-income patients.
“While medication copays for Medicaid enrollees are low, evidence from our previous study and preliminary data suggest that multiple copays may still cause substantial financial stress for some patients,” Dr. Surbhi said. “Strategies, such as eliminating medication copays and providing medications at the hospital bedside and through home delivery, improve medication adherence and reduce hospitalizations. That being said, these strategies have not been rigorously assessed in Medicaid super-utilizers.”
According to a study published in the Annals of Internal Medicine, medication nonadherence is an obstacle to achieving optimal treatment goals and is associated with 125,000 deaths, 10 percent of hospitalizations, and between $100 to $289 billion in health care costs each year. Dr. Surbhi will use her grant to conduct a randomized controlled trial to examine strategies that could improve medication adherence for vulnerable, low-income patients in real-world settings. Findings from this study will serve as the foundation for a larger randomized controlled trial.
“Vulnerable patients experience major gaps in care during and after transitions from hospital to community setting,” Dr. Surbhi said. “Thus, my long-term goal is to develop targeted, sustainable interventions to improve adherence to essential chronic medications, improve health outcomes, and reduce costs among vulnerable low-income patients with chronic diseases.”
Dr. Surbhi’s 2019 Research Starter Grant In Health Outcomes will be funded for one year and will include contributions from investigators at UTHSC, Emory University, and the University of Southern California. Dr. Surbhi’s current study builds on a previous Centers for Medicare & Medicaid Services Health Care Innovation Award funded program called SafeMed. Dr. Surbhi is currently providing research support for a UTHSC CORNET Disparities Grant and a funding opportunity through the Patient-Centered Outcomes Research Institute. She earned her PhD in Health Outcomes and Policy Research at UTHSC in 2016 and was appointed an assistant professor in 2017.