Journal of Managed Care Pharmacy最新文献

{"title":"Administrative Databases and Outcomes Assessment: An Overview of Issues and Potential Utility","authors":"S. Gandhi, J. W. Salmon, S. Kong, Sean Z. Zhao","doi":"10.18553/JMCP.1999.5.3.215","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.3.215","url":null,"abstract":"OBJECTIVE: To make health care researchers, clinicians, and managers who are relatively new to outcomes research using administrative databases more aware of issues to consider when planning or conducting studies, and to encourage improvement in the data quality and structure of administrative databases. CONCLUSION: Administrative databases are being used more frequently in the assessment of health care interventions. Their increased popularity as a research tool can be attributed to timely availability, the large patient populations they cover, low cost, and applicability in the real world. However, there are limitations to their use as an outcomes assessment tool due to their structure, the data collection processes and the inherent nature of the U.S. health care delivery system.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.18553/JMCP.1999.5.3.215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67487880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Rule-Based Program to Describe Antibiotic Utilization for Otitis Media Among Three Medical Plans","authors":"G. Reardon, A. Pleil, Allan F. Zaenger","doi":"10.18553/JMCP.1999.5.3.233","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.3.233","url":null,"abstract":"OBJECTIVE: The purpose of this study was to develop and test an analytical technique for describing variations in the antibiotic prescribing process for otitis media (OM) in ambulatory medical plans. DESIGN: Using medical, hospital, and pharmacy claims over an 18-month period, a computerized rule-based system identified which antibiotics were probable therapies for OM. For each patient and OM episode of treatment, the rule based system recorded the ordinal sequencing of specific antibiotics, including first-line and follow-up choices, to treat the OM condition. SETTING: Three medical plans in the Midwest were studied: a Medicaid-funded IPA-model HMO; an employer-funded, indemnity-based PPO; and an employer-funded \"at-risk\" network. RESULTS: The number of OM antibiotics dispensed per subject was similar among plans. For first-line therapy, inexpensive penicillinase-sensitive penicillins, trimethoprim-sulfamethoxazole, and erythromycin-sulfisoxazole, combined, accounted for 74.6%, 47.2%, and 47.7% of total ...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67487981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Considerations in the Management of Arthritis","authors":"R. A. Zabinski","doi":"10.18553/JMCP.1999.5.6.476","DOIUrl":"https://doi.org/10.18553/JMCP.1999.5.6.476","url":null,"abstract":"iatroge.nic disease in patients with arthri- tis is substantial. In a population of Medicaid recipients, 25% of patients taking nonsteroidal antiinflammatory drugs (NSAlDs) experienced side effects that required further medical care. The costs of treating these side effects were accounted for primarily by drugs (42%) and physician visits (20%). However, hospitalization for complications, such as gastrointestinal (GO bleeding, per- foration, or obstruction, although un- common, accounted for 38% of iatro-","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Claims Data Analysis of Patient Acquisition","authors":"A. Carlson","doi":"10.18553/jmcp.1999.5.4.342","DOIUrl":"https://doi.org/10.18553/jmcp.1999.5.4.342","url":null,"abstract":"OBJECTIVE: To determine frequency of claims for inhaled beta2-agonist and anti-inflammatory agents and the adequacy of acquisition represented by claims in a population of patients with asthma receiving health services in managed care organizations. DESIGN: A retrospective, observational study using medical and pharmacy claims from an automated database. SETTING: Five affiliated IPA-model health plans located in four geographic regions of the United States with total annual approximate enrollment of 870,000 members. PATIENTS: 27,834 asthmatics of either sex and less than 64 years of age with asthma claims from July 1, 1993-June 30, 1994. MAIN OUTCOME MEASURES: The number of claims for inhaled beta 2-agonist and anti-inflammatory agents was used to determine patterns of drug acquisition. Number of canisters and days supply for each claim were used to determine level of acquisition from linked claims histories. Three categories of acquisition level were defined: less than 150 days (1-3 claims) in 12 months=...","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managed Care Pharmacy Practice at the Texas Tech University Health Sciences Center School of Pharmacy","authors":"R. Patry","doi":"10.18553/jmcp.1999.5.6.556","DOIUrl":"https://doi.org/10.18553/jmcp.1999.5.6.556","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67488987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Improvement, Risk Management, and Patient Education: Tools to Reduce Medication Error","authors":"L. Norton","doi":"10.18553/JMCP.2001.7.2.156","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.2.156","url":null,"abstract":"SUMMARY: Upon completion of this continuing education program, participants will be able to: 1. Explain the purpose of accreditation and accreditation standards and their limitation. 2. Differentiate quality, consistency, and safety. 3. Discuss tools for assuring quality and predicting failure within systems. 4. Describe a process for conducting a root-cause analysis. 5. Discuss actions pharmacy and pharmacists can take to reduce medication errors. 6. List steps that patients can take to help prevent medication errors.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"227 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Measures: Looking in All the Wrong Places","authors":"A. Wertheimer","doi":"10.18553/jmcp.2001.7.2.88","DOIUrl":"https://doi.org/10.18553/jmcp.2001.7.2.88","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oregon State University Partners with Medicaid and a Managed Care Organization","authors":"K. Ketchum","doi":"10.18553/JMCP.2001.7.3.185","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.3.185","url":null,"abstract":"","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employer-Sponsored Health Care Services","authors":"M. Dillion","doi":"10.18553/JMCP.2001.7.3.189","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.3.189","url":null,"abstract":"mployer-sponsored health care is a concept that may be unfamiliar to many managed care pharmacists. It deserves close examination because it is an idea that has been well received and effective. It was developed to help midto large-sized employers contract for primary care and pharmacy services in a manner that is cost-effective and convenient for employees (both current and retired) and often their dependents as well. Its goal is to reduce costs while improving access and quality of care. The outcomes—reduced health care costs, improved quality of care, increased worker productivity, and lower absenteeism— are well worth the investment.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Bears Responsibility for Glucocorticoid-Exposed Patients in a Large Health Maintenance Organization?","authors":"B. Ettinger, A. Pressman, H. Shah","doi":"10.18553/JMCP.2001.7.3.228","DOIUrl":"https://doi.org/10.18553/JMCP.2001.7.3.228","url":null,"abstract":"OBJECTIVE: High exposure to glucocorticoid drugs is associated with an increased risk of osteoporosis and fracture. To define the degree to which individual prescribers needed to adjust their prescribing practices and thus to pre vent glucocorticoid-induced osteoporosis among their patients, this research sought to identify both the health plan members who had high exposure to glucocorticoid drugs and the physicians who prescribed these drugs. DESIGN: Patient demographic characteristics, diagnoses, and medications were determined for members of the Kaiser Foundation Health Plan of Northern California who received more than two grams of prednisone (or its equivalent) during any 12-month period from 1998 through 1999. RESULTS: High exposure to glucocorti coid drugs was identified in 22,444 health plan members, accounting for about 1% of adult health plan members. High exposure to glucocorticoi d drugs increased sixfold from about 0.5% in members 20–30 years old to about 3% in members 70–79 years old; among these members, 3,788 physicians prescribed the glucocorticoid drugs that led to high exposure. The highest numbers of highly exposed patients were seen among rheumatologists and oncologists. Nephrologists, pulmonologists, and gastroenterologists had an intermediate number of highly exposed patients. Internists had the lowest number of highly exposed patients per physician, yet prescribed glucocorticoid drugs to the largest group (40%) of highly exposed patients in the study. CONCLUSIONS: Using a pharmacy database system developed to identify patients exposed to potentially harmful amounts of glucocorticoi d drugs, we identified high glucocorticoid exposure in 1%–3% of health plan members more than 50 years old. In addition, grouping prescribing physicians by medical specialty showed that the need to adjust prescribing practices to prevent glucocorticoid-related complications was unevenly distributed among specialty groups. To improve quality of care for patients in managed care organizations who have high exposure to glucocorticoi d drugs, systems for preventive identification and intervention should be developed using pharmacy databases, and should be tailored to physician specialty.","PeriodicalId":50156,"journal":{"name":"Journal of Managed Care Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.18553/JMCP.2001.7.3.228","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67489956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}