Document Detail


Intervention to reduce unnecessary dispensing of short-acting {beta}-agonists in patients with asthma.
MedLine Citation:
PMID:  20233916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several clinical studies have suggested that the overuse of short-acting beta-agonists (SABAs) and the underuse of inhaled corticosteroids are prevalent and may compromise patient health and increase the use of scarce health-care resources. OBJECTIVE: To examine the impact of an intervention designed to reduce SABA metered-dose inhaler (MDI) overdispensing on asthma-related drug and healthcare utilization endpoints in a mail order pharmacy benefit population. METHODS: Retrospective pre- and postintervention analysis was conducted on all new SABA prescriptions indicating a quantity more than 1 SABA MDI per month and on asthma patients who were continuously enrolled in the Medco Health Solutions prescription benefit program from July 1, 2006, to June, 30, 2007 (preintervention), and July 1, 2007, to June 30, 2008 (postintervention). The intervention involved a written or verbal request to the prescriber to reduce the quantity of SABA MDIs dispensed to less than 1 SABA MDI per month if determined appropriate by the prescriber. Effectiveness of the intervention on asthma-related drug and health-care utilization outcomes were measured in the overall Medco pharmacy population and in asthma patients receiving more than 1 SABA MDI per month. RESULTS: The percentage of new SABA prescriptions dispensed for more than 1 SABA MDI per month was significantly reduced during year 2 (22.9% vs 9.7%, p < 0.01). Of the 1835 asthma patients who received more than 1 SABA MDI per month in year 1, 1230 (67%) received fewer than 1 SABA MDI per month during year 2. The incidence of asthma-related hospitalizations, emergency department visits, and oral corticosteroid use did not significantly change from year 1 to year 2. CONCLUSIONS: This analysis shows that an intervention can succeed in reducing the overdispensing of quick-relief medication without compromising asthma control. Further investigation is warranted to better understand the interplay between reduction in excessive SABA use and improved clinical outcomes.
Authors:
Mark D Wong; R Thomas Manley; Glen Stettin; William Chen; Luis M Salmun
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Publication Detail:
Type:  Journal Article     Date:  2010-03-16
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  44     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  623-9     Citation Subset:  IM    
Affiliation:
Pulmonary Therapeutic Resource Center, Medco Health Solutions, Inc., Liberty Lake, WA 99019, USA. mark_wong@medco.com
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects,  economics,  therapeutic use
Adrenergic beta-Agonists / adverse effects*,  economics,  therapeutic use
Adult
Aged
Asthma / drug therapy*,  economics
Cohort Studies
Cost Savings
Databases, Factual
Drug Prescriptions / statistics & numerical data
Drug Utilization
Female
Humans
Logistic Models
Male
Middle Aged
Patient Education as Topic*
Pharmacists*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Adrenergic beta-Agonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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