Innovative Diffusion of Comparative Effectiveness Research

描述(由申请人提供)：比较有效性研究的创新扩散研究摘要(马龙：PI)数百万美国人在医院和管理的护理机构接受治疗，这些机构实施了药房和治疗(P&T)委员会，以支持和鼓励安全有效的药物处方。这些委员会及其支持的临床医生不断评估证据，以确保患者接受最适当的治疗。P&T委员会的程序主要包括通过文献搜索、制造商提供的信息和FDA批准的标签收集可用的证据。基于这一证据，临床药剂师和其他健康专业人员开发了一本P&T专著。P&T委员会将在审议中使用这本专著和其他辅助文件，并最终做出影响药物使用方式的决定。尽管对药剂师和医生进行了广泛的临床培训，但比较有效性研究(CER)方法并不是他们培训的常见组成部分。此外，人们对P&T过程中CER证据的认识和实际使用知之甚少。为了识别和填补CER方法现有知识中的关键空白，并增加现有和未来医疗研究与质量机构(AHRQ)支持的证据审查的使用，该研究团队将进行一系列需求评估和创新的量身定制的培训计划。参与者将从管理保健药房学院、美国卫生系统药房协会、P&T协会、印度卫生服务机构和国家医疗补助主任协会(NASMD)的成员中征集。这项研究将调查药剂师和医生对CER指南的认识，然后确定在P&T过程中使用这些审查所需的关键技能。第二阶段将包括为临床医生，尤其是药剂师和医生提供P&T过程中针对CER的专门培训。这项研究将评估培训课程的有效性，以加强CER方法的知识和能力，并提高对CER指南的认识。第三阶段将确定与未参加CER培训计划的相匹配的临床医生队列相比，完成培训计划的人在多大程度上将CER指南(包括传播以患者和临床医生为导向的指南)纳入P&T流程。这项研究将增强P&T委员会将CER纳入用药政策和程序的能力，并在医院、管理性护理组织和服务不足的人群中广泛传播现有的CER指南。 与公共健康相关：数百万美国人在医院和管理下的医疗机构接受治疗，这些机构设有药房和治疗(P&T)委员会，其主要目的是鼓励安全有效地开出药物处方。这些委员会不断评估证据，以确保患者接受最适当的治疗。该提案提供了一种策略，以提高这些委员会对医疗保健研究与质量机构(AHRQ)有效医疗保健计划的比较有效性研究(CER)指南的认识和采用。

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.