Positive impact of a follow-up phone call to community pharmacies in a medicaid drug utilization program

• Published in: The Annals of pharmacotherapy 1999-05, Vol.33 (5), p.541-547
• Main Authors: Culbertson, VL, Force, RW, Cady, PS, Force, WS
• Format: Article
• Language: English
• Subjects: Anti-Ulcer Agents - administration & dosage; Biological and medical sciences; Clinical Trials as Topic; Data Collection; Female; General aspects; Humans; Male; Medicaid; Medical sciences; Middle Aged; Pharmacies - standards; Planification. Prevention (methods). Intervention. Evaluation; Practice Patterns, Physicians' - standards; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Telephone; United States
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1345/aph.18266

OBJECTIVE: To evaluate the impact of including community pharmacists in strategies to alter excessive prescribing of antiulcer medications (AUMs) in a statewide drug utilization review (DUR) program. Mailing educational materials to physicians is a common intervention strategy of retrospective DUR programs. However, pharmacists are typically left out of this process, ignoring a possibly influential healthcare provider. METHODOLOGY: Patients without gastroesophageal reflux disease who received ≥1.0 normalized therapeutic equivalents (e.g., 1.0 NTE = ranitidine 300 mg/d or omeprazole 20 mg/d) for five of six prior months were included. The pharmacists and physicians of these patients were divided into one of three geographically distinct groups: group 1 physicians received mailed materials only (pharmacists were not contacted); group 2 physicians and pharmacists received mailed materials only; and group 3 physicians and pharmacists received mailed materials, and the pharmacists were contaced by phone. Mean NTE and AUM costs were analyzed six months before and six months following the intervention. RESULTS: One hundred thirty-eight, 329, and 248 patients were included in G1, G2, and G3, respectively. There was a 12.4%, 8.0%, and 14.0% reduction in NTE for G1, G2, and G3, respectively. G1 AUM cost decreased 7.7% ($7710); G2 decreased 6.8% ($14 037); G3 decreased 20.5% ($26 722). The total decrease in AUM cost for the entire cohort from before to after the intervention was $48 469 (p < 0.05) in the six months following the intervention. CONCLUSIONS: A follow-up phone call to pharmacists in a statewide DUR intervention enhances the effectiveness of DUR interventions under the conditions studied. Enlisting the support of community pharmacists may improve the cost savings of these interventions. EXTRACTO OBJETIVO: Enviar por correo material educativo a los médicos es una estrategia de intervención común de los programas de revisión de uso de medicamentos (RUM). Sin embargo, típicamente los farmacéuticos no se incluyen en el proceso, ignorando un posible proveedor de cuidado de salud de gran influencia. Este estudio evaluó el impacto de incluir a los farmacéuticos de comunidad en las estrategias para alterar la prescripción excesiva de medicamentos anti-úlceras (MAU) en un programa estatal de RUM. MÉTODO: Se incluyeron pacientes sin diagnóstico de enfermedad de reflujo gastroesofágico que recibieron >1.0 equivalentes terapéuticos normalizados (1.0 ETN = ranitidina