Electronic Pharmacotherapy Risk Management

NCT ID: NCT00828490

Last Updated: 2010-03-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

174000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-07-31

Study Completion Date

2010-03-31

Brief Summary

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The purpose of the Utah ePRM (electronic Pharmacotherapy Risk Management) project is to improve quality and safety of medication use while simultaneously controlling costs and detecting fraud and abuse.

Detailed Description

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The ePRM project has two objectives:

1. Refine and implement a computerized surveillance and trigger tool to support medication therapy and risk management services. The ePRM tool will be used to (1) identify potential drug-therapy problems, which include quality, safety and cost-related problems; (2) select patients and providers for in-depth clinical reviews and possibly direct intervention (i.e., letter, phone call, Medication Therapy Management Services (MTMS), or Academic Detailing); (3) identify potential fraud and diversion of controlled substances; and (4) track patterns of medication use and evaluate ePRM performance, identify improvements, and direct policy change.
2. Conduct innovative multi-pronged interventions that are guided by the ePRM trigger tool. Clinical areas chosen for review include diabetes therapy, hypertension, asthma, antipsychotic therapy, pain management (opioid narcotics and anticonvulsants) and anticoagulation/antiplatelet drugs. Interventions in these areas will address potential under and overuse, or patient safety concerns. Clinical pharmacists and physicians will implement five types of inter-related interventions: a) provider level reviews, which includes prescribers' profiling and feedback for outlier prescribers; b) patient level reviews and letters to prescribers for high-risk patients; c) phone consultation and Academic Detailing with outlier prescribers; d) MTMS; and e) detecting and pursuing suspected fraud and abuse cases.

Conditions

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Asthma Mental Health Pain

Study Design

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Study Time Perspective

RETROSPECTIVE

Study Groups

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Pediatric Asthmatics

Medicaid beneficiaries ≤21 years of age who meet the HEDIS criteria for persistent asthma

provider feedback

Intervention Type BEHAVIORAL

The provider-level intervention includes a targeted review of trigger-flagged beneficiaries' drug utilization history and an information packet sent to providers which includes patient-specific pharmacy and medical claims history, patient specific recommendations, and provider comparative profiling.

patient intervention

Intervention Type BEHAVIORAL

The patient intervention arm includes the provider-level intervention mentioned above in addition to Medication Therapy Management Services (MTMS), a program that provides patients one-on-one therapy counseling administered by community pharmacists who have completed an MTMS certificate program.

Process-level

Intervention Type BEHAVIORAL

The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit

Antipsychotic Therapy

Medicaid beneficiaries ≥18 years of age and enrolled ≥6 months of the past 12 months with enrollment in at least one of the past 3 months and ≥3 antipsychotic Rx within past 12 months

provider feedback

Intervention Type BEHAVIORAL

The provider-level intervention includes a targeted review of trigger-flagged beneficiaries' drug utilization history and an information packet sent to providers which includes patient-specific pharmacy and medical claims history, patient specific recommendations, and provider comparative profiling.

patient intervention

Intervention Type BEHAVIORAL

The patient intervention arm includes the provider-level intervention mentioned above in addition to Medication Therapy Management Services (MTMS), a program that provides patients one-on-one therapy counseling administered by community pharmacists who have completed an MTMS certificate program.

Process-level

Intervention Type BEHAVIORAL

The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit

Bipolar Therapy

Medicaid beneficiaries ≥18 years of age and enrolled ≥6 months of the past 12 months with enrollment in at least one of the past 3 months and a diagnosis of Bipolar in past 3 years, and ≥ 1 antidepressant Rx in past 6 months, and no mood stabilizer in past 6 months.

provider feedback

Intervention Type BEHAVIORAL

The provider-level intervention includes a targeted review of trigger-flagged beneficiaries' drug utilization history and an information packet sent to providers which includes patient-specific pharmacy and medical claims history, patient specific recommendations, and provider comparative profiling.

patient intervention

Intervention Type BEHAVIORAL

The patient intervention arm includes the provider-level intervention mentioned above in addition to Medication Therapy Management Services (MTMS), a program that provides patients one-on-one therapy counseling administered by community pharmacists who have completed an MTMS certificate program.

Process-level

Intervention Type BEHAVIORAL

The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit

Opioid Therapy

Medicaid beneficiaries ≥18 years and enrolled ≥6 of prior 12 months with enrollment in ≥1 of prior 3 months and ≥1 opioid fill in prior 3 months and none of the following in prior 12 months:

Hospice CPT code or Primary diagnosis of cancer or Oncology CPT code

Process-level

Intervention Type BEHAVIORAL

The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit

Fraud and Abuse

Medicaid beneficiaries who filled at least 3 opioid Rx in the last 12 months

No interventions assigned to this group

Pediatric Antipsychtotic Therapy

Medicaid beneficiaries \<18 years of age with at least 3 antipsychotic Rx's in the past year.

No interventions assigned to this group

Interventions

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provider feedback

The provider-level intervention includes a targeted review of trigger-flagged beneficiaries' drug utilization history and an information packet sent to providers which includes patient-specific pharmacy and medical claims history, patient specific recommendations, and provider comparative profiling.

Intervention Type BEHAVIORAL

patient intervention

The patient intervention arm includes the provider-level intervention mentioned above in addition to Medication Therapy Management Services (MTMS), a program that provides patients one-on-one therapy counseling administered by community pharmacists who have completed an MTMS certificate program.

Intervention Type BEHAVIORAL

Process-level

The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All medicaid recipients and providers with in the salt lake area

Exclusion Criteria

* each participant much be a Medicaid recipient
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Utah Department of Health

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role lead

Responsible Party

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University of Utah

Principal Investigators

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Jonathan R Nebeker, M.D., M.S.

Role: PRINCIPAL_INVESTIGATOR

VASLCHCS

Gary Oderda, PharmD, M.P.H.

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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Multi-clinic site

Salt Lake City, Utah, United States

Site Status

Countries

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United States

Other Identifiers

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7570516-1

Identifier Type: -

Identifier Source: secondary_id

24987

Identifier Type: -

Identifier Source: org_study_id

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