IMPACT OF PROSPECTIVE DRUG USE REVIEW ON HEALTH

描述：宾夕法尼亚州佩斯计划，州级门诊患者 老年人药物援助计划，实施精神药物 ProDUR于1995年3月推出。佩斯的ProDUR系统可以被描述为 本质上是监管性质的。没有规定药剂师优先于 ProDUR警报。一个以信息化为特征的ProDUR系统是 1994年6月在宾夕法尼亚州的医疗补助计划中实施。医疗补助S ProDUR系统确实允许药剂师优先。 这个拟议的项目有两个具体目标。第一个是 进行精神药物使用的描述性流行病学分析， ProDUR屏幕故障的处方模式和成品率。这只手臂 这项研究检查了ProDUR前后两个24个月的时间段 干预措施，并计算与毒品相关的结果衡量标准的估计 (一阶结果)。第二个目标是评估独立性 两种不同的ProDUR程序对健康结局的影响，包括 药物使用(一级结果)和随后(或二级) 改变处方做法的结果，包括差异 死亡率、发病率和服务利用率。有两项研究发表在 符合这些目标的拟议研究：1)描述性研究 DUR处方模式与DUR筛查失败的流行病学分析 适用的与监管和信息ProDUR程序相关的费率 精神药物治疗(Profile研究)，以及2)结果 与适用于的信息和监管ProDUR系统相关联 精神药物治疗(结果研究)。 在48个月内按每个月计算的度量值 观察期包括以下内容： -每月精神药物使用情况：任何用途是/不是 -每月治疗类用药：是/否 -按月分列的特定药物精神药物使用情况 -按月按具体精神药物用量分列的药物剂量 -供应的天数有多准确，因此剂量数据？ -每月精神药物的新使用情况 -在治疗期间增加精神药物剂量，按月增加。 多么 治疗的一段插曲是“定义的”吗？ -Pace ProDur屏幕故障，按月-使用宾夕法尼亚州DUR 筛选器应允许估计ProDUR筛选器故障率 医疗补助文件将直接与佩斯的费率相媲美。 -按月分列的新申领个案总数 -每月续装总次数 -每月方案中的治疗课程总数-作为替代 为 并存疾病。 国际和平研究所预计还将制定一系列与使用 作为审查故意和非精神药物的一部分的非精神药物 ProDUR的意外影响：

DESCRIPTION: The Pennsylvania PACE program, a state-level outpatient pharmaceutical assistance program for the elderly, implemented psychotropic ProDUR in March, 1995. PACE's ProDUR system can be characterized as Regulatory in nature. There is no provision for pharmacist overrides of ProDUR alerts. A ProDUR system - characterized as informational - was implemented in Pennsylvania's Medicaid program in June 1994. Medicaid s ProDUR system does allow pharmacist overrides. There are two specific aims in this proposed project. The first is to conduct a descriptive epidemiological analysis of psychotropic drug use, prescribing patterns, and yield of ProDUR screen failures. This arm of the study examines two 24 month periods, before and after the ProDUR interventions, and computes estimates of drug-related outcome measures (first order outcomes). The second aim is to evaluate the independent effects of two different ProDUR procedures on health outcomes, including both drug use (first order outcomes) and consequent (or second order) outcomes from changes in prescribing practices, including differential mortality, morbidity, and service utilization. There are two studies in the proposed research which correspond to these aims: 1) a descriptive epidemiological analysis of DUR prescribing patterns and DUR screen failure rates associated with Regulatory and Informational ProDUR procedures applied to psychotropic drug therapies (The Profile Study), and 2) outcomes associated with informational and regulatory proDUR systems as applied to psychotropic drug therapies (The Outcomes Study). Measures to be computed for each individual for each month over the 48 month observation period include the following: - Psychotropic use by month: yes/no for any use - Therapeutic class use by month: yes/no by class - Drug-specific psychotropic use by month - Drug dosage-specific psychotropic use by month - How accurate are the days supply, hence dosage data? - New use of psychotropics by month - Increased psychotropic dosage within episode of therapy, by month. How is an episode of therapy "defined"? - Failure of PACE ProDur Screens, by month - Using the Penn State DUR Screener should allow estimation of ProDUR screen failure rates in Medicaid files that will be directly comparable to PACE rates. - Total number of new claims by month - Total number of refills by month - Total number of therapeutic classes in regimen by month-as a proxy for co-morbidities. The PI anticipates also developing a number of measures related to use of non-psychotropic drugs as part of the examination of intentional and unintentional impacts of ProDUR: