Impact of an educational intervention for secondary prevention of myocardial infarction on Medicaid drug use and cost.
Am J Manag Care
; 10(7 Pt 2): 493-500, 2004 Jul.
Article
em En
| MEDLINE
| ID: mdl-15298236
ABSTRACT
OBJECTIVES:
The objectives of this drug utilization review program were (1) to increase beta-blocker prescribing to fee-for-service post-acute myocardial infarction (AMI) Medicaid patients; (2) to improve compliance among patients who were prescribed beta-blockers post-AMI; and (3) to evaluate the economic implications of increased beta-blocker prescribing. STUDYDESIGN:
Pre-post nonequivalent group design. PATIENTS ANDMETHODS:
The intervention targeted physicians of Pennsylvania Medicaid recipients who had an AMI between November 1, 1998, and November 1, 1999. Educational materials were sent to the physicians of post-AMI patients not receiving beta-blockers. Preintervention and postintervention rates of beta-blocker prescribing in the Medicaid program within 7 and 30 days of discharge after an AMI hospitalization were compared. Similarly, pre- and postintervention compliance rates were compared for AMI patients who were prescribed beta-blockers. Cost savings and number of avoided deaths also were calculated.RESULTS:
There was a 5.5%, to 6.9% increase in beta-blocker prescribing after the intervention, depending on the follow-up period. Postintervention AMI patients were 16% more likely to be prescribed a beta-blocker. There was an 8.3% increase in patient compliance with beta-blocker therapy from preintervention to postintervention. In the first 2 years of the intervention, the estimated cost savings to the Pennsylvania Medicaid program ranged from 71,970 dollars to 76,678 dollars, respectively. An estimated 3 deaths were avoided.CONCLUSIONS:
The intervention resulted in increased appropriate prescribing and compliance with beta-blockers among post-AMI patients. There also were estimated cost savings to Pennsylvania Medicaid as a result of reduced hospitalization, and fewer deaths.
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Base de dados:
MEDLINE
Assunto principal:
Educação de Pacientes como Assunto
/
Medicaid
/
Custos de Medicamentos
/
Antagonistas Adrenérgicos beta
/
Infarto do Miocárdio
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article