Improving Medication - Related Outcomes

The objective of the Center for Improving Medication-Related Outcomes is to identify medication-related problems and to implement interventions that result in the improvement of patient-related and cost outcomes. The Center's specific aims are to identify and describe the causes of the most serious medication-related problems in Kentucky, to develop and study the effectiveness of interventions designed to improve outcomes in the priority problem-prone therapteutic areas, to implement effective interventions and thereby improve medication-related outcomes, and to disseminate information and tools that will assist others in the implementation of effective interventional strategies. Hence, there are two types of projects within this proposal; those that identify problems and those that are interventions. Problem identification projects will employ data mining and decision analysis methods. Data bases available for mining include the Kentucky Medicaid Information System, Kentucky Hospital Discharge database, data from all Kentucky psychiatric hospitals, and eligibility and claims data from two Kentucky health plans. With regard to decision analysis four approaches will be used; decision trees (model uncertainty in treatment decisions, costs of therapeutic options, cost impact of policy changes), ethnographic decision modeling (understand and document the decision processes of providers and patients), multiattribute utility modeling (reveal objectives in treatment decisions), and contingent valuation (assess patient preferences). These problem identification projects will be used to investigate medication-related issues concerning antiarthritic medications, narcotic painkillers, antipsychotics and diabetes patients. With regard to interventions the primary objective will be to change the behavior of patients and health care professionals thereby improving the use of medications in patients. The two primary interventions will involve communication-education and academic detailing methods. In the communication-education intervention three approaches will be used (patient-provider communication (PACE system), conlict management and media literacy) in an attempt to positively influe~ce the use of ~ntibioticS in ?hildren. In the academic detailing intervention social marketing and adult edu?~tlon meth.ods will b~ used t? .Improve the management of type 2 diabetes through influencing the prescnblng behavior of famllty physIcians.`