The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Karen L Rascati - One of the best experts on this subject based on the ideXlab platform.
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Drug Utilization Review of concomitant use of specific serotonin reuptake inhibitors or clomipramine with antianxiety sleep medications
Clinical Therapeutics, 1995Co-Authors: Karen L RascatiAbstract:Side effects of some antidepressants include anxiety and insomnia. A retrospective Drug Utilization Review was conducted to determine the amount of concurrent use of an antidepressant with medication that may counteract these side effects. Texas Medicaid claims data for 1993 included more than 30,000 patients receiving a specific serotonin reuptake inhibitor (SSRI) or clomipramine. A total of 35.0% of these patients were also taking a medication that could be used to relieve anxiety or induce sleep, and 15.2% of the total were receiving once-daily dosing of the latter type of medication. Concomitant use of SSRIs or clomipramine with trazodone occurred in 7.7% of the patients.
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Drug Utilization Review of concomitant use of specific serotonin reuptake inhibitors or clomipramine with antianxiety/sleep medications
Clinical therapeutics, 1995Co-Authors: Karen L RascatiAbstract:Side effects of some antidepressants include anxiety and insomnia. A retrospective Drug Utilization Review was conducted to determine the amount of concurrent use of an antidepressant with medication that may counteract these side effects. Texas Medicaid claims data for 1993 included more than 30,000 patients receiving a specific serotonin reuptake inhibitor (SSRI) or clomipramine. A total of 35.0% of these patients were also taking a medication that could be used to relieve anxiety or induce sleep, and 15.2% of the total were receiving once-daily dosing of the latter type of medication. Concomitant use of SSRIs or clomipramine with trazodone occurred in 7.7% of the patients.
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Effects of Medicaid Drug Utilization Review intervention letters
Clinical therapeutics, 1995Co-Authors: Gary J. Okano, Karen L RascatiAbstract:Abstract The state of Texas Drug Utilization Review (DUR) Board, composed of six physicians and six pharmacists, meets quarterly to determine criteria for implementing retrospective DUR. The board agreed to send intervention letters to physicians concurrently prescribing: (1) two histamine 2 (H 2 )-antagonists (H 2 As) or (2) either any H 2 A or omeprazole with sucralfate. To measure the effect of these intervention letters, approximately half of these physicians were randomly chosen to receive a letter while the others served as a control group and did not receive letters. This project focused on the H 2 A or omeprazole with sucralfate intervention letters in a two-step process. Data on concurrent therapy involving two H 2 As were analyzed separately and these results are not included in this report. Objective one was to examine feedback from the physicians who received the letters, and objective two was to Review and compare patient profiles 6 months after the letters were sent. Analysis of Medicaid prescription claims indicated that 190 physicians had concurrently prescribed either an H 2 A or omeprazole with sucralfate for 222 patients. Ninety-seven physicians (from 117 identified patient profiles) were selected to receive an intervention letter with their patient's profile or profiles, a response form, and a stamped envelope addressed to the Texas Department of Human Services. A 67.5% response rate was obtained. Of these responses, 49.4% agreed with the letter and 29.1% disagreed with the letter. The remaining indicated responses such as "not my patient," they were no longer seeing the patient, or that they did not prescribe the medication in question. Results of objective two indicated that 57.9% of the experimental group and 75.3% of the control were still receiving H 2 A or omeprazole with sucralfate concurrent therapy after the 6-month postintervention observation period. This statistically significant reduction ( P = 0.011) in the percentage of patients receiving concurrent therapy for the experimental group, when compared with the control group, along with the high physician response rate and moderately high agreement rate, indicate that intervention letters are an appropriate way to inform physicians of potentially inappropriate prescribing.
Helene Levens Lipton - One of the best experts on this subject based on the ideXlab platform.
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Computer-Based Drug-Utilization Review — Risk, Benefit, or Boondoggle?
The New England journal of medicine, 1995Co-Authors: Stephen B. Soumerai, Helene Levens LiptonAbstract:On October 28, 1990, with little debate, Congress passed the Omnibus Budget Reconciliation Act, requiring the states to provide claims-based Drug-Utilization Review to approximately 34 million Medicaid enrollees.1,2 The provisions of the program were borrowed from the ill-fated Medicare Catastrophic Coverage Act of 1988, repealed in 1990; the stated goals were to reduce potentially inappropriate prescribing and dispensing of medications, enhance the counseling of patients, and reduce growth in expenditures for Drugs.1 Drug-Utilization Review is a structured, ongoing program that interprets patterns of Drug use in relation to predetermined criteria and attempts to prevent or minimize inappropriate prescribing.3, . . .
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computer based Drug Utilization Review risk benefit or boondoggle
The New England Journal of Medicine, 1995Co-Authors: Stephen B. Soumerai, Helene Levens LiptonAbstract:On October 28, 1990, with little debate, Congress passed the Omnibus Budget Reconciliation Act, requiring the states to provide claims-based Drug-Utilization Review to approximately 34 million Medicaid enrollees.1,2 The provisions of the program were borrowed from the ill-fated Medicare Catastrophic Coverage Act of 1988, repealed in 1990; the stated goals were to reduce potentially inappropriate prescribing and dispensing of medications, enhance the counseling of patients, and reduce growth in expenditures for Drugs.1 Drug-Utilization Review is a structured, ongoing program that interprets patterns of Drug use in relation to predetermined criteria and attempts to prevent or minimize inappropriate prescribing.3, . . .
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Drug Utilization Review in ambulatory settings: state of the science and directions for outcomes research.
Medical care, 1993Co-Authors: Helene Levens Lipton, Joyce Adair BirdAbstract:There are escalating national pressures to analyze pharmaceutical outcomes and to develop Drug-related clinical guidelines. These interests coincide with passage of the Medicaid Rebate Law (OBRA, 1990), which mandates the implementation of prospective and retrospective Drug Utilization Review (DUR)
C. Burch - One of the best experts on this subject based on the ideXlab platform.
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Drug Utilization Review of sedative hypnotic agents in texas medicaid patients
Journal of the American Pharmaceutical Association, 2000Co-Authors: Jennifer K. Seltzer, T. L. Kurt, Leroy C. Knodel, B. Dean, C. BurchAbstract:Objective: To assess use of sedative/hypnotic agents in Texas Medicaid patients and evaluate practitioner receptiveness to intervention letters concerning sedative/hypnotic prescribing generated by the Texas Medicaid Drug Utilization Review (DUR) Board. Design Retrospective DUR. Setting: Texas Medicaid retrospective DUR program. Patients or Other Participants: 244 Texas Medicaid patients and 291 Texas physicians Intervention: Patient profiles for Texas Medicaid patients were Reviewed retrospectively to quantify sedative/hypnotic prescribing practices. Intervention letters were prepared and sent to physicians directly involved in the care of patients receiving excessive sedative/hypnotic therapy. Physician responses were categorized based on information presented in the intervention letter and circumstances surrounding the identified patient. Prescribing practices were assessed approximately 1 year after the intervention to determine the impact of intervention letters on prescribing. Main Outcome Measure: Physician response to interI vention letter. Results: Responses were received from 208 of 291 physicians (71.5%). Approximately 40% of physicians agreed in principle with the suggestions offered by the Texas Medicaid DUR Board to minimize chronic sedative/hypnotic use. Almost one-half of these physicians had discontinued sedative/hypnotic therapy for the identified patients 1 year after the intervention. Approximately 9% justified continued sedative/hypnotic use based on patient diagnosis or refractory response to treatment, and 55 physicians (26.4%) were unwilling to alter therapy because of patient-specific factors. Conclusion: Through the use of retrospective DUR, Texas Medicaid patients receiving excessive amounts of sedative/hypnotic agents were identified and improvements in sedative/hypnotic therapy were initiated. DUR can be useful not only in identifying problem areas, but also in encouraging physicians to modify prescribing practices through educational means.
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Drug Utilization Review of sedative/hypnotic agents in Texas Medicaid patients. Texas Medicaid Vendor Drug Program Drug Utilization Review Board.
Journal of the American Pharmaceutical Association (Washington D.C. : 1996), 2000Co-Authors: Jennifer K. Seltzer, T. L. Kurt, Leroy C. Knodel, B. Dean, C. BurchAbstract:Objective To assess use of sedative/hypnotic agents in Texas Medicaid patients and evaluate practitioner receptiveness to intervention letters concerning sedative/hypnotic prescribing generated by the Texas Medicaid Drug Utilization Review (DUR) Board. Design Retrospective DUR. Setting Texas Medicaid retrospective DUR program. Patients or other participants 244 Texas Medicaid patients and 291 Texas physicians. Intervention Patient profiles for Texas Medicaid patients were Reviewed retrospectively to quantify sedative/hypnotic prescribing practices. Intervention letters were prepared and sent to physicians directly involved in the care of patients receiving excessive sedative/hypnotic therapy. Physician responses were categorized based on information presented in the intervention letter and circumstances surrounding the identified patient. Prescribing practices were assessed approximately 1 year after the intervention to determine the impact of intervention letters on prescribing. Main outcome measure Physician response to intervention letter. Results Responses were received from 208 of 291 physicians (71.5%). Approximately 40% of physicians agreed in principle with the suggestions offered by the Texas Medicaid DUR Board to minimize chronic sedative/hypnotic use. Almost one-half of these physicians had discontinued sedative/hypnotic therapy for the identified patients 1 year after the intervention. Approximately 9% justified continued sedative/hypnotic use based on patient diagnosis or refractory response to treatment, and 55 physicians (26.4%) were unwilling to alter therapy because of patient-specific factors. Conclusion Through the use of retrospective DUR, Texas Medicaid patients receiving excessive amounts of sedative/hypnotic agents were identified and improvements in sedative/hypnotic therapy were initiated. DUR can be useful not only in identifying problem areas, but also in encouraging physicians to modify prescribing practices through educational means.
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Drug Utilization Review of sedative hypnotic agents in texas medicaid patients texas medicaid vendor Drug program Drug Utilization Review board
Journal of the American Pharmaceutical Association, 2000Co-Authors: Jennifer K. Seltzer, T. L. Kurt, Leroy C. Knodel, B. Dean, C. BurchAbstract:Objective To assess use of sedative/hypnotic agents in Texas Medicaid patients and evaluate practitioner receptiveness to intervention letters concerning sedative/hypnotic prescribing generated by the Texas Medicaid Drug Utilization Review (DUR) Board. Design Retrospective DUR. Setting Texas Medicaid retrospective DUR program. Patients or other participants 244 Texas Medicaid patients and 291 Texas physicians. Intervention Patient profiles for Texas Medicaid patients were Reviewed retrospectively to quantify sedative/hypnotic prescribing practices. Intervention letters were prepared and sent to physicians directly involved in the care of patients receiving excessive sedative/hypnotic therapy. Physician responses were categorized based on information presented in the intervention letter and circumstances surrounding the identified patient. Prescribing practices were assessed approximately 1 year after the intervention to determine the impact of intervention letters on prescribing. Main outcome measure Physician response to intervention letter. Results Responses were received from 208 of 291 physicians (71.5%). Approximately 40% of physicians agreed in principle with the suggestions offered by the Texas Medicaid DUR Board to minimize chronic sedative/hypnotic use. Almost one-half of these physicians had discontinued sedative/hypnotic therapy for the identified patients 1 year after the intervention. Approximately 9% justified continued sedative/hypnotic use based on patient diagnosis or refractory response to treatment, and 55 physicians (26.4%) were unwilling to alter therapy because of patient-specific factors. Conclusion Through the use of retrospective DUR, Texas Medicaid patients receiving excessive amounts of sedative/hypnotic agents were identified and improvements in sedative/hypnotic therapy were initiated. DUR can be useful not only in identifying problem areas, but also in encouraging physicians to modify prescribing practices through educational means.
Stephen B. Soumerai - One of the best experts on this subject based on the ideXlab platform.
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Computer-Based Drug-Utilization Review — Risk, Benefit, or Boondoggle?
The New England journal of medicine, 1995Co-Authors: Stephen B. Soumerai, Helene Levens LiptonAbstract:On October 28, 1990, with little debate, Congress passed the Omnibus Budget Reconciliation Act, requiring the states to provide claims-based Drug-Utilization Review to approximately 34 million Medicaid enrollees.1,2 The provisions of the program were borrowed from the ill-fated Medicare Catastrophic Coverage Act of 1988, repealed in 1990; the stated goals were to reduce potentially inappropriate prescribing and dispensing of medications, enhance the counseling of patients, and reduce growth in expenditures for Drugs.1 Drug-Utilization Review is a structured, ongoing program that interprets patterns of Drug use in relation to predetermined criteria and attempts to prevent or minimize inappropriate prescribing.3, . . .
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computer based Drug Utilization Review risk benefit or boondoggle
The New England Journal of Medicine, 1995Co-Authors: Stephen B. Soumerai, Helene Levens LiptonAbstract:On October 28, 1990, with little debate, Congress passed the Omnibus Budget Reconciliation Act, requiring the states to provide claims-based Drug-Utilization Review to approximately 34 million Medicaid enrollees.1,2 The provisions of the program were borrowed from the ill-fated Medicare Catastrophic Coverage Act of 1988, repealed in 1990; the stated goals were to reduce potentially inappropriate prescribing and dispensing of medications, enhance the counseling of patients, and reduce growth in expenditures for Drugs.1 Drug-Utilization Review is a structured, ongoing program that interprets patterns of Drug use in relation to predetermined criteria and attempts to prevent or minimize inappropriate prescribing.3, . . .
Sergio I. Prada - One of the best experts on this subject based on the ideXlab platform.
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Comparing the Medicaid Prospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies in 2015 and 2016.
American health & drug benefits, 2019Co-Authors: Sergio I. Prada, Johan S LoaizaAbstract:Background The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR process and involves electronically monitoring prescription Drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR involving ongoing, periodic examinations of claims data to identify patterns of fraud, abuse, underUtilization, Drug-Drug interaction, and medically unnecessary care, and implement corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure the prescription Drug cost-savings generated from its DUR programs annually, but it provides no methodology for doing so. An earlier article compared the methodologies used by states to measure cost-savings in their retrospective DUR program in fiscal years 2014 and 2015. Objective To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid prospective DUR program in federal fiscal years 2015 and 2016. Methods For each state, we downloaded from Medicaid's website the cost-savings methodologies included in the Medicaid DUR 2015 and 2016 reports. We then Reviewed and synthesized the reports. Methods described by the states were classified into a unique group based on the methodology used, except for Arkansas and Connecticut, which were classified in more than 1 category for the same period. Results Currently, 3 different methodologies are being used by states. In 2015 and 2016, the most common methodology used (by 18 states) was the calculation of total claim rejections and subtracting claim resubmissions at the amount actually paid. The comparisons of DUR program cost-savings among states are unreliable, because the states lack a common methodology in the way they measure their performance. Conclusions Considering the lack of methodologic consistency among states in measuring the savings in the Medicaid DUR program shown in this analysis, the federal government must lead an effort to define a unique methodology to measure cost-savings in its entire DUR program. This will help to improve the measure of savings among states and understand how this program is performing in that matter.
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Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies
American health & drug benefits, 2017Co-Authors: Sergio I. PradaAbstract:Background The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription Drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underUtilization, Drug-Drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription Drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. Objectives To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. Method For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then Reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. Discussion In 2014, the most often used prescription Drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. Conclusion There is great variation among states in the methods used to measure prescription Drug Utilization cost-savings. This analysis suggests that there is still room for improvement in terms of methodology transparency, which is important, because lack of transparency hinders states from learning from each other. Ultimately, the federal government needs to evaluate and improve its DUR program.
