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Claims-based retrospective drug util...

Hennessy, Sean Patrick.

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Claims-based retrospective drug utilization review programs: Are they effective?

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Claims-based retrospective drug utilization review programs: Are they effective?/
作者:	Hennessy, Sean Patrick.
面頁冊數:	145 p.
附註:	Adviser: Brian L. Strom.
Contained By:	Dissertation Abstracts International63-02B.
標題:	Health Sciences, Health Care Management. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3043886
ISBN:	0493577831

Claims-based retrospective drug utilization review programs: Are they effective?
Hennessy, Sean Patrick.

Claims-based retrospective drug utilization review programs: Are they effective? - 145 p.

Adviser: Brian L. Strom.

Thesis (Ph.D.)--University of Pennsylvania, 2002.

Study programs issued alerts (usually a letter to the prescriber) for 1% to 25% of drug therapy problems.

ISBN: 0493577831Subjects--Topical Terms:

1017922
Health Sciences, Health Care Management.

Claims-based retrospective drug utilization review programs: Are they effective?
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100 1 $a Hennessy, Sean Patrick. $3 1261782
245 1 0 $a Claims-based retrospective drug utilization review programs: Are they effective?
300 $a 145 p.
500 $a Adviser: Brian L. Strom.
500 $a Source: Dissertation Abstracts International, Volume: 63-02, Section: B, page: 0756.
502 $a Thesis (Ph.D.)--University of Pennsylvania, 2002.
520 $a Study programs issued alerts (usually a letter to the prescriber) for 1% to 25% of drug therapy problems.
520 $a Using pre- and post-implementation data, we looked for an effect of RDUR on the frequency of exceptions. We were unable to detect an effect, even in high dose subgroups.
520 $a Retrospective Drug Utilization Review (RDUR) programs use computerized administrative data to intervene on apparently problematic prescribing. Interventions occur after the prescription has been dispensed. Such programs are required of all US Medicaid programs and are commonly used by private insurers. We studied the effectiveness of Medicaid RDUR programs in reducing the frequency of apparent drug therapy problems (exceptions) and in improving clinical outcomes in patients with exceptions.
520 $a We also examined whether drug therapy problems occurring after RDUR implementation resulted in hospital admission less often than those occurring pre-implementation. Again, we were unable to discern an effect of RDUR, including in high dose and high risk subgroups.
520 $a Our results suggest that RDUR programs, as currently implemented, are ineffective in affecting future prescribing or reducing the risk of hospitalization among those with an exception. A number of factors may be responsible, including the low alert rate, the questionable validity of the criteria, and the inefficacy of retrospectively mailed alert letters to improve prescribing. Given the lack of evidence that RDUR programs, as implemented, are effective in improving clinical outcomes, and the potential for unintended consequences of such programs, policymakers should consider withdrawing the mandate for such programs. Improved versions of RDUR should be shown to be effective before being implemented. An agenda for future research on improving medication use is presented.
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