Innovative Diffusion of Comparative Effectiveness Research

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DESCRIPTION (provided by applicant): Innovative Diffusion of Comparative Effectiveness Research Abstract (Malone: PI) Millions of Americans are treated in hospitals and managed care organizations that have implemented pharmacy and therapeutic (P&T) committees to support and encourage safe and effective prescribing of medications. These committees and their supporting clinicians continually evaluate evidence to ensure that patients' receive the most appropriate therapy. The P&T committee process primarily involves collecting available evidence via literature searches, manufacturer supplied information, and the FDA- approved labeling. Based on this evidence a P&T monograph is developed by clinical pharmacists and other health professionals. The P&T committee will use this monograph and other supporting documents in deliberations, and ultimately in making decisions that affect the manner in how medicines are used. Despite extensive clinical training for pharmacists and physicians, comparative effectiveness research (CER) methods have not been a common component of their training. In addition, little is known about the awareness and actual use of CER evidence in the P&T process. To identify and fill critical gaps in existing knowledge of CER methods and to increase the use of existing and future Agency for Healthcare Research and Quality (AHRQ) supported evidence reviews, this research team will conduct a series of needs assessments and innovative, tailored training programs. Participants will be solicited from the memberships of the Academy of Managed Care Pharmacy, American Society for Health-System Pharmacy, The P&T Society, Indian Health Service, and National Association of State Medicaid Directors (NASMD). This study will investigate awareness of CER guides by pharmacists and physicians and then identify critical skills needed to use these reviews in the P&T process. The second phase will consist of providing CER- specific training to clinicians, most notably pharmacists and physicians, in the P&T process. The study will assess the effectiveness of the training sessions to enhance knowledge and competency in CER methods and to increase awareness of CER guides. The third phase will determine the extent to which CER guides, including dissemination of patient- and clinician- oriented guides, are incorporated into the P&T processes by those completing the training programs as compared to a matched cohort of clinicians not participating in the CER training programs. This study will enhance the ability of P&T committees to incorporate CER into medication-use policies and procedures and generate wide-spread diffusion of existing CER guides in hospitals, managed care organizations, and underserved populations. PUBLIC HEALTH RELEVANCE: Millions of Americans are treated in hospitals and managed care organizations that have pharmacy and therapeutic (P&T) committees whose primary purpose is to encourage safe and effective prescribing of medications. These committees continually evaluate the evidence to ensure that patients' receive the most appropriate therapy. This proposal provides a strategy to increase awareness and adoption of the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program's comparative effectiveness research (CER) guides by these committees.