Arizona Center for Education and Research on Therapeutics

描述（由申请人提供）：亚利桑那CERT （AzCERT）是亚利桑那大学（UA）和关键路径研究所（C-Path）的联盟，关键路径研究所是位于亚利桑那州图森的非营利组织。AzCERT在预防与药物相互作用（ddi）相关的药物不良反应（ADDRs）方面有六年的经验，特别是那些伤害妇女的药物。本申请扩展了这一主题，使用系统方法来检查潜在的人为和系统因素，这些因素负责共同处方，共同分配和共同管理具有相互作用（pddi）和引起adr的药物组合。我们的具体目标是：1)通过减少pddi来改善患者安全；2)通过减少addr来改善健康结果。研究将检查以提供者为目标和以患者为目标的干预措施对pddi和addr的有效性。AzCERT将继续与退伍军人管理局医疗保健系统进行卓有成效的合作，以评估向医生发出预防pddi和addr警报的有效性。我们还将评估“近实时”传真警报计划的有效性，该计划包括医疗保险D部分处方者，以预防药物管理呼叫中心（UA和Caremark）的pddi和addr。我们将评估在社区环境（包括临床实验室和社区卫生中心）开展的创新性PDDI教育干预措施，并抓住患者等待抽血监测华法林、地高辛和其他药物治疗的“教育时刻”。AzCERT将开发和评估创新的“培训师”项目，作为UA护理、医学和药学学院跨专业课程的一部分。AzCERT有完善的国际（基于网络的）、国家、地区和社区教育和传播计划，这些计划都是基于AzCERT和其他机构进行的研究。国际公认的QTdrugs.org网站（2005年访问量为36万）将通过与FDA、Lincoln Technologies和DrugLogic的合作，扩大并加强互动。我们将与FDA、AMA和美国临床药理学学院（American College of Clinical Pharmacology）一起，通过多种途径（包括一个新的网站www.warfarin-ddi.org）告知供应商和患者华法林的DDI和基于基因的新剂量。在这个应用程序中，我们将极大地扩展我们的传播工作，包括前美国外科医生Richard Carmona的公共服务公告。所有这些工作将侧重于循证、文化敏感的干预措施、全面评估和传播与患者相关的信息，特别是与西班牙裔、美洲原住民和亚利桑那州服务不足的城市和农村人口相关的信息。传播将通过与AZ CHCs协会、临床实验室、地区健康教育中心（AHEC）、UA农业合作推广学院和Cox Cable的合作关系来促进。AzCERT将通过合作伙伴关系来利用联邦资金，扩大我们的影响范围和改善患者健康结果的能力。

DESCRIPTION (Provided by the Applicant): The Arizona CERT (AzCERT) is a consortium of the University of Arizona (UA) and the Critical Path Institute (C-Path), a non-profit organization in Tucson, AZ. The AzCERT has six years of experience in the prevention of adverse drug reactions (ADDRs) associated with drug-drug interactions (DDIs), especially those that harm women. This application expands on this theme using a systems approach to examine the underlying human and systems factors responsible for the co-prescription, co-dispensing and co-administration of drug combinations that have the potential to interact (PDDIs) and cause ADDRs. Our specific aims are to 1) improve patient safety by reducing PDDIs and 2) improve health outcomes by reducing ADDRs. Research will examine the effectiveness of provider-targeted and patient-targeted interventions on PDDIs and ADDRs. The AzCERT will continue its very productive collaborations with the Veterans Administration Healthcare System to evaluate the effectiveness of alerts to physicians for preventing PDDIs and ADDRs. We will also evaluate the effectiveness of a "near real time" fax alert program that includes Medicare Part D prescribers for prevention of PDDIs and ADDRs in medication management call centers (UA and Caremark). We will evaluate innovative PDDI educational interventions that take place in community settings, including clinical laboratories and community health centers (CHC) and capture the "teachable moment" when patients are waiting to have blood drawn for monitoring warfarin, digoxin and other drug therapies. AzCERT will develop and evaluate innovative "train-the-trainer" programs as part of the inter-professional curriculum in the UA colleges of nursing, medicine and pharmacy. The AzCERT has well-established international (web-based), national, regional and community educational and dissemination programs that are based on research conducted by AzCERT and others. The internationally recognized website, QTdrugs.org (360,000 visits in 2005) will be expanded and made more interactive through collaborations with the FDA, Lincoln Technologies and DrugLogic. Together with the FDA, AMA and the American College of Clinical Pharmacology, we will inform providers and patients about DDI and new gene-based dosing for warfarin through multiple approaches including a new website, www.warfarin-ddi.org. In this application, we will greatly expand our dissemination efforts to include public service announcements featuring former U.S. Surgeon General Richard Carmona. All of this work will focus on evidence-based, culturally sensitive interventions, thorough evaluation and dissemination of information that is relevant to patients, especially the Hispanic, Native American and under-served urban and rural populations in AZ. Dissemination will be facilitated by collaborative relationships with the AZ Association of CHCs, clinical laboratories, the Area Health Education Centers (AHEC), UA College of Agriculture Cooperative Extension and Cox Cable. The AzCERT will leverage the federal funding for this grant through partnerships that extend our reach and our ability to improve health outcomes for patients.