{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:21:55Z","timestamp":1747196515418,"version":"3.40.5"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Integrated care models (ICMs) might be an effective strategy to improve patients\u2019 quality of care. The aim of this study was to compare different ICMs such as family-doctor models, and a standard care model (SCM) regarding patients\u2019 drug safety in Swiss primary care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed an observational study using health insurance claims data from patients who were continuously enrolled in an ICM or in a SCM between 2020 and 2021. ICMs included family-doctor model (FDM), family-doctor model light (FDM-light) and the telemedicine model (TM). Drug safety was assessed by the prescription of potentially inappropriate proton pump-inhibitors (PIPPI), opioids (PIO), medications (PIM), and polypharmacy. Propensity-score-weighted multiple logistic regression models were used to examine the association between different types of ICMs and drug safety.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Patients in FDM had significantly lower odds of receiving PIPPI (OR, 0.86; CI 95%, 0.83\u20130.89), PIO (OR, 0.81; CI 95%, 0.76\u20130.85), PIM (OR, 0.94; CI 95%, 0.91\u20130.97), and polypharmacy (OR, 0.94; CI 95%, 0.91\u20130.97) compared to patients in SCM. Potentially inappropriate prescribing was also lower in patients in TM and partly in FDM-light than in SCM. Persons enrolled in FDM were less likely to receive PIM (OR, 0.93; CI 95%, 0.89\u20130.97) and polypharmacy (OR, 0.94; CI 95%, 0.90\u20130.99) than those in FDM-light, whereas the odds of receiving PIPPI and polypharmacy were higher in FDM than in TM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>ICMs were significantly associated with higher drug safety compared to SCM for most outcomes. Findings suggest that patients may benefit most from ICMs with a high degree of coordination or gatekeeping. ICM may represent an effective approach to improve patients\u2019 drug safety and, thus, to reduce the risk of adverse events.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311099","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T17:27:55Z","timestamp":1727371675000},"page":"e0311099","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are integrated care models associated with improved drug safety in Swiss primary care? an observational analysis using healthcare claims data"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2553-377X","authenticated-orcid":true,"given":"Renato","family":"Farcher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sereina M.","family":"Graber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Boes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola A.","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"author":"S Twerenbold","key":"pone.0311099.ref001","article-title":"Helsana-Report: Arzneimittel: Kosten auf Rekordhoch."},{"article-title":"Monitoringsystems Sucht und NCD.: Kosten des Gesundheitswesens","year":"2023","author":"Schweizer Monitoring-System Sucht und nicht\u00fcbertragbare Krankheiten (MonAM).","key":"pone.0311099.ref002"},{"key":"pone.0311099.ref003","doi-asserted-by":"crossref","first-page":"3269","DOI":"10.1007\/s11136-023-03473-3","article-title":"Treatment bur-den and health-related quality of life of patients with multimorbidity: a cross-sectional study.","volume":"32","author":"EA Gebreyohannes","year":"2023","journal-title":"Qual Life Res"},{"key":"pone.0311099.ref004","doi-asserted-by":"crossref","first-page":"e491","DOI":"10.3399\/BJGP.2020.1048","article-title":"Prevalence and predictors of potentially inappropriate prescribing in middle-aged adults: a repeated cross-sectional study.","volume":"71","author":"A Khatter","year":"2021","journal-title":"Br J Gen Pract"},{"key":"pone.0311099.ref005","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s40267-019-00700-1","article-title":"A prospective observational pilot study of adverse drug reactions contributing to hospitalization in a cohort of middle-aged adults aged 45\u201364 years.","volume":"36","author":"T Smeaton","year":"2020","journal-title":"Drugs & Therapy Perspectives."},{"key":"pone.0311099.ref006","doi-asserted-by":"crossref","first-page":"e2326910","DOI":"10.1001\/jamanetworkopen.2023.26910","article-title":"Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide: A Systematic Review and Meta-Analysis","volume":"6","author":"F Tian","year":"2023","journal-title":"JAMA Netw Open"},{"key":"pone.0311099.ref007","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s00228-021-03257-z","article-title":"Who gets prescriptions for proton pump inhibitors and why? 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