CURATA: A patient health management program for the treatment of osteoarthritis in Québec: an integrated approach to improving the appropriate utilization of anti-inflammatory/analgesic medications.
Am J Manag Care
; 10(8): 569-75, 2004 Aug.
Article
em En
| MEDLINE
| ID: mdl-15352533
ABSTRACT
OBJECTIVES:
To identify gaps in current osteoarthritis (OA) care in Quebec, Canada, and to implement and evaluate interventions to promote appropriate use of evidence-based medicine. STUDYDESIGN:
Pretest and posttest; analysis of the Quebec health insurance database.METHODS:
CURATA is a patient health management program utilizing an evidence-based approach for OA treatment. Evaluation of the current level of care revealed major gaps in physicians' knowledge of (1) risk factors for gastrointestinal (GI) toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs); (2) NSAID-induced toxicity associated with long-term administration and contraindications for NSAID use in patients with hypertension, cardiovascular disease, or renal insufficiency; (3) choice of cytoprotection; and (4) use of nonpharmacologic treatments for OA. The CURATA intervention consisted of educational workshops, with and without presentation of a decision tree regarding appropriate use of pharmacologic and nonpharmacologic OA treatments. Participating physicians were asked to complete an 8-item questionnaire before and after the workshop, as well as 3 and 6 months later, to test their immediate and remote knowledge of treatment choices. The prescribing patterns of GPs also were evaluated through analysis of the Quebec health insurance database.RESULTS:
The participating physicians were better immediate and remote risk assessors of GI bleeding and made more appropriate treatment choices (15.2% improvement relative to mean preworkshop score).CONCLUSION:
These evidence-based interventions were successful not only in improving the physicians' knowledge regarding the diagnosis and management of OA, but also--more importantly--in changing their behavior to make more appropriate therapy choices for their patients.
Buscar no Google
Coleções:
01-internacional
Temas:
Fomentar_producao_conhecimento_especifico
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Osteoartrite
/
Analgésicos
/
Anti-Inflamatórios
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Implementation_research
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Ano de publicação:
2004
Tipo de documento:
Article