Study Results
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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COMPLETED
174000 participants
OBSERVATIONAL
2007-07-31
2010-03-31
Brief Summary
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Detailed Description
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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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Study Design
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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
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
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
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
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
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
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
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
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
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
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.
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.
Process-level
The process-level intervention includes the provider-level intervention plus in-clinic evidence-based quality improvement workshops with opportunity for CME credit
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
ALL
No
Sponsors
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Utah Department of Health
OTHER
University of Utah
OTHER
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
Countries
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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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