DUR: What's New and Upcoming Projects
Atypical Antipsychotic ProjectThe atypical antipsychotic education project, "Fiscal Pharmacology of the Atypical Antipsychotics: Getting the Biggest Bang Out of the Bucks," continues to expand. This is an initiative of Medi-Cal DUR, the Department of Health Care Services (DHCS) and University of California at San Diego Graduate Department of Continuing Education, with industry representation from Janssen Pharmaceutica, Eli Lilly and Co., Pfizer Inc., AstraZeneca, Abbott Laboratories and Bristol-Myers Squibb Co. In addition, the Neuroscience Education Institute, a team of 15 practitioners and a panel of seven independent reviewers have been integral to the project.
The education program has been presented at over 17 venues within California and 11 venues nationally. The collaborative group will schedule at least four additional venues. Over 4,200 printed programs and another 4,200 CD ROMs of the program have been mailed to health care providers. Two articles describing the project have been published in the Psychiatric Times (June 2002) and Psychopharmacology Newsletter (September 2002) and additional publications are anticipated. A method of evaluating the outcome of educational efforts related to this program is currently under development.
To request a copy of the program, worth six hours of Category I credit towards the American Medical Association's Physician Recognition Award, write to the following address and include your name and mailing address:
Neuroscience Education InstituteAntibiotic Resistance
Attention Course Coordinator
5857 Owens Avenue, Suite 102
Carlsbad, CA 92009
The Alliance Working for Antibiotic Resistance Education (AWARE) is a large collaborative effort led by the California Medical Association and involving many groups and individuals in California, from parent-teacher organizations to private health plans. Medi-Cal DUR participates in both the steering committee and subcommittees to address the problem of antibiotic overuse in California. AWARE is hosting a national conference about appropriate antibiotic uses on November 2 – 3, 2002. This conference will feature representatives from statewide and national organizations, including the Centers for Disease Control. For more information, or to register for this event, visit the AWARE Web site.
Long Term Care ProjectMedi-Cal DUR is involved in a long term care project, "Evaluation of Long Term Care Drug Use by Drug Class and Diagnosis," focused on using DUR information to better understand the current health care issues for seniors and patients in long term care facilities. The long term care project is a collaboration of Medi-Cal DUR, the California Pharmacists Association Long Term Care Management Council and the University of Southern California (USC) School of Pharmacy. The evaluation program has changed its focus from two studies to a single study on vertebral fractures and fractures of the femur neck as proxies for osteoporosis.
Upcoming Projects
Asthma Therapy
A growing number of clinical programs and studies are using claims data to compare clinical practice patterns against published care standards. In general, these claims analyses are not validated with a direct clinical assessment of a patient's health status and therefore do not directly predict health status. DUR, however, intends to take Medi-Cal claims data and link it to the data collected at the patient chart level. Then, a validated prediction model will be developed, showing that adherence to prescription fill patterns is directly related to clinical outcomes. The objective of this project is to develop a model that uses administrative claims data to predict: The objective of this project is to develop a model that uses administrative claims data to predict:
- Patient asthma health status
- Quality of pharmacological care relative to health status
- Relationships between pharmacological care standards and health care costs
Arthritis Project
An arthritis project, "Classification of Practice Patterns, Treatment Outcomes, & Costs for Chronic Inflammatory Arthritis in the Medi-Cal Population," is in its early stages of design. The primary objectives of the project are to:
- Identify associations between distinguishing factors (i.e., diagnostic and therapeutic procedures) for the purpose of classifying patients identified in Medi-Cal claims data into groupings based on diagnostic features and patterns of care
- Examine the specific determinants associated with each patient classification grouping
- Investigate important outcomes associated with each patient classification grouping (i.e., number of doctors treating patient, early vs. late referral from generalists to specialists, over-prescribing of corticosteroids, healthcare service utilization and costs)
- Identify regional, facility, and provider-related patterns and use those findings as a foundation for future research to guide improvements in arthritis care and policy