EFFECTIVENESS OF RETROSPECTIVE DRUG UTILIZATION REVIEW

回顾性药物利用审查的有效性

• 批准号: 2855842
• 负责人: BRIAN LESLIE STROM
• 金额: $ 25.85万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-03-15 至 2000-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2855842
• 关键词: angina pectoris; antiinflammatory agents; asthma; behavioral /social science research tag; chronic obstructive pulmonary disease; clinical research; drug adverse effect; gastritis; health care service evaluation; health care service utilization; hemorrhage; hospital utilization; human data; myocardial infarction; peptic ulcer; pharmacy; salicylate; warfarin

Improper prescribing of medications is an important public health problem. Because the aged are more likely to have concomitant illnesses and medications, they are at greatest risk for adverse outcomes. For example, one study conducted in the elderly found that 28% of hospital admissions were due to medication problems, and showed that Medicaid recipients were at an especially increased risk. Drug utilization review (DUR) is a procedure that seeks to reduce the consequences of improper prescribing. In part because of federal mandate, retrospective DUR is now being applied to millions of older Americans, including all Medicaid enrollees and seventy- five percent of all people with prescription insurance coverage. This is despite the complete absence of rigorous evidence indicating that DUR is effective in either altering drug therapy or improving health outcomes. Given the existing federal mandate, an experimental trial of DUR in the Medicaid population is infeasible. Therefore, a timely, well-controlled observational trial of DUR's effectiveness is badly needed. The University of Pennsylvania has a unique opportunity to conduct a rigorous observational trial of DUR's effects on prescribing patterns and on clinical outcomes. Using a large, unique data source, we intend to evaluate the effects of DUR on both process measures and clinical outcome measures. The methodology that we propose incorporates both pre-post intervention comparisons, and concurrent controls. This will enable us to measure a number of important effects of DUR, controlling for possible effects of differences between state programs and causally unrelated secular trends. We intend to employ three distinct, complementary sampling frames from which to pose the study questions. The study questions have been carefully selected, and address issues of practical and theoretical importance. The results of this study, whether positive or negative, will have wide-ranging health policy and scientific implications, especially with regard to the aged. The University of Pennsylvania has a great deal of experience in pharmaceutical outcomes research projects such as this, especially those using large claims databases. The investigators will be able to provide clear, meaningful answers to the study questions in a very short time-frame, and do so in a very cost-efficient manner.

处方不当是一个重要的公共卫生问题

项目成果

Nonsedating antihistamines should be preferred over sedating antihistamines in patients who drive.

对于开车的患者，非镇静性抗组胺药应优先于镇静性抗组胺药。

• DOI: 10.7326/0003-4819-132-5-200003070-00011
• 发表时间: 2000
• 期刊: Annals of internal medicine
• 影响因子: 39.2
• 作者: Hennessy,S;Strom,BL
• 通讯作者: Strom,BL

Retrospective drug utilization review, prescribing errors, and clinical outcomes.

回顾性药物使用审查、处方错误和临床结果。

• DOI: 10.1001/jama.290.11.1494
• 发表时间: 2003
• 期刊: JAMA : the journal of the American Medical Association
• 作者: Hennessy,Sean;Bilker,WarrenB;Zhou,Lan;Weber,AnitaL;Brensinger,Colleen;Wang,Yanlin;Strom,BrianL
• 通讯作者: Strom,BrianL