Table 1.
Disease-Specific Criteria for Inclusion in the Study
| Disease | Inclusion Criteria | Exclusion Criteria | Any Acceptable Medications |
|---|---|---|---|
| Asthma | Patents were included if they were ≥4 years of age and had 1 medical encounter with asthma (ICD-9 code 493.xx) as the primary diagnosis OR at least 2 outpatient encounters with asthma as a secondary diagnosis OR a diagnosis and an asthma medication fill. | Patents were excluded if they had any diagnosis of emphysema or COPD. | Cromolyn, inhaled corticosteroids (ICS), ICS + long-acting beta agonists (LABA) fixed-dose combination, leukotriene modifiers (LTM), and xanthines |
| Chronic obstructive pulmonary disease (COPD) | Patients were included if they were ≥40 years of age and had 1 medical encounter with a primary diagnosis of COPD (ICD-9 code 491.xx, 492.xx, or 496.xx) or 2 with secondary diagnoses of COPD. | None | Anticholinergics (AC), LTM, xanthines, and IC + LABA, short-acting beta agonist (SABA) + AC fixed-dose combinations. |
| Coronary artery disease (CAD) | Patients were included if they had a diagnosis of CAD (ICD-9 codes 410.x to 414.x or 429.2x). | None | Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blocker (ARB), beta-blockers, anticoagulants, antiplatelets, and any fixed-dose combination product of any of these. |
| Depression | Patients were included if they had 1 medical encounter with major depression (ICD-9 codes 296.2, 296.3, 298.0, 300.4, 309.1, or 311) as the primary diagnosis OR 2 outpatient or 1 inpatient encounters with secondary diagnoses | Patients with schizophrenia or bipolar disorder were excluded. | Monoamine oxidase inhibitors, selective norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, tricyclic antidepressants, and other antidepressants |
| Diabetes | Patients were included if they had 2 medical encounters for diabetes (ICD-9 code 250.xx), or 1 medical encounter for diabetes and a prescription fill for insulin, or an oral antidiabetic medication, or 1 prescription fill for insulin. | Patients were excluded if they had only 1 inpatient or outpatient encounter for type 1 diabetes and lacked a prescription fill for insulin or an oral antidiabetic medication. | Alpha-glucosidase inhibitors, biguanides, D-phenylalanine derivative, meglitinides, sulfonylureas, thiazolidinedione, or any fixed dose combination of these. Insulin was included in any appropriate medication percentages and excluded in any appropriate oral medication percentage and adherence measures. |
| Heart Failure | Patients were included if they had a diagnosis of heart failure (ICD-9 codes 398.91, 428.xx, 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 404.03, 404.13, 404.93) | None | ACE inhibitors, alpha-beta blockers, ARB, beta-blockers, calcium channel blockers, digitalis, direct vasodilators, diuretics, nitrates, antiarrythmias, anticoagulants, antiplatelets, any appropriate lipid-lowering medication, or any fixed-dose combination product of any of these. |
| Hyperlipidemia | Patients were included if they had a diagnosis of hyperlipidemia (ICD-9 codes 272.0-272.4 or 272.9) or had a prescription fill for at least 1 antihyperlipidemic agent. | Patients were excluded if they had evidence of CAD (ICD-9 codes 410.x to 414.x, or 429.2x). | Statins, bile acid sequestrants, or other antihyperlipidemic medications (clofibrate, gemfibrozil, nicotinic acid, ezetimibe, and fenofibrate). |
| Hypertension | Patients were included if they were diagnosed with hypertension (ICD-9 codes 401.xx to 405.xx). | Patients were excluded if they had evidence of heart failure (ICD-9 codes 398.91, 428.xx, 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 404.03, 404.13, 404.93), stroke (434.91, 434.11, 430, 431, 432.0-432.9, 434.01), or myocardial infarction (410.x1). | ACE inhibitors, alpha-adrenergic agonists, alpha-beta blockers, ARB, beta-blockers, calcium channel blockers, central alpha agonists, direct vasodilators, diuretics, peripheral agents, and any fixed-dose combination product of any of these. |