{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:40:07Z","timestamp":1761093607433,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T00:00:00Z","timestamp":1506556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007920","name":"University of Massachusetts Medical School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Progesterone (hydroxyprogesterone caproate injection and vaginal progesterone) has been shown to reduce preterm birth (<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>) rates by a third among pregnant women at high risk. The purpose of this analysis is to report birth outcomes and medication adherence among Massachusetts Medicaid (MassHealth) members receiving progesterone, evaluate the association between member characteristics and birth outcomes and medication adherence, and compare cost of care with a prior preterm pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study used medical claims, pharmacy claims, and prior authorization (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>) request data for MassHealth members who had a <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> submitted for progesterone between January 1, 2011, and March 31, 2015. Members were excluded due to breaks in coverage, progesterone was not indicated for prevention of <jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>, and if current gestational week or date of delivery was unavailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>A total of 418 members were screened for inclusion of whom 190 met criteria and 169 filled progesterone. Mean age was 29.2 years (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> = 5.23), and clinical comorbidities were identified in 90.5% of members. Consistent with clinical trials on progesterone effectiveness, 62.1% of members had a term delivery (37 wks of gestation). Among members with prior gestational age at delivery available, the average difference in gestational age between pregnancies was 8.25 weeks (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> = 6.11). In addition, 66.3% of members were adherent to progesterone based on proportion of days covered (<jats:styled-content style=\"fixed-case\">PDC<\/jats:styled-content>) of 0.8 or higher. The overall mean <jats:styled-content style=\"fixed-case\">PDC<\/jats:styled-content> was 0.79 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> = 0.26).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite similar birth outcomes in clinical trials and national trends, medication adherence is low in this state Medicaid program. Therefore, members may benefit from adherence support.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2020","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T03:56:41Z","timestamp":1503374201000},"page":"1328-1334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Progesterone Utilization and Birth Outcomes in a State Medicaid Plan"],"prefix":"10.1002","volume":"37","author":[{"given":"Tasmina","family":"Hydery","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Services University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mylissa K.","family":"Price","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Services University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie C.","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Services University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mito","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Services University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parag S.","family":"Kunte","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Research University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose P.","family":"Mauro","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Services University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Lenz","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Research University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul L.","family":"Jeffrey","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Research University of Massachusetts Medical School Shrewsbury Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,28]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"March of Dimes.Premature birth report card;2016. Available fromhttp:\/\/www.marchofdimes.org\/materials\/premature-birth-report-card-united-states.pdf. Accessed December 6 #bib2016."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182723b1b"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6532a4"},{"key":"e_1_2_7_5_1","first-page":"31","volume-title":"Preterm birth: causes, consequences, and prevention","author":"Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes","year":"2007"},{"key":"e_1_2_7_6_1","unstructured":"March of Dimes.Premature birth: the financial impact on business December2013. Available fromhttp:\/\/www.marchofdimes.org\/materials\/premature-birth-the-financial-impact-on-business.pdf. 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