Support for this study was provided to Wilson by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number ULI TR001860. The content of this article is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. The authors have nothing additional to disclose.

BACKGROUND: Clinical trials evaluating the efficacy of dabigatran followed a very strict protocol, which included close monitoring and follow-up. Patients followed in this controlled environment had an average medication possession ratio (MPR) > 0.95. However, very few studies have evaluated patient adherence to dabigatran in a real-world setting. Other studies of chronic medications indicate patients are not reliably adherent to twice daily regimens. Adherence to therapy is particularly important for direct thrombin inhibitors because there may be a risk of increased thromboembolic events associated with poor adherence to these agents.

Objectives. To determine whether a peer-to-peer education program was an expedient and effective approach to improve knowledge and promote interprofessional communication and collaboration. Design. Trained pharmacy students taught nursing students, medical students, and medical residents about the Medicare Part D prescription drug benefit (Part D), in 1-to 2-hour lectures. Assessment. Learners completed a survey instrument to assess the effectiveness of the presentation and their attitudes toward the peer-to-peer instructional format. Learners strongly or somewhat agreed that the peer-to-peer format was effective in providing Part D education (99%) and promoted interprofessional collaboration (100%). Qualitative data highlighted the program's clinical relevance, value in promoting interprofessional collaboration, and influence on changing views about the roles and contributions of pharmacists. Conclusion. The Part D peer educator program is an innovative way to disseminate contemporary health policy information rapidly, while fostering interprofessional collaboration.

No outside funding supported this study. The authors report no conflicting interests. Melnikow and Cutler contributed the study concept and design, with assistance from the other authors. Lester, Barca, and She collected the data, and Xin performed all statistical analysis. Cutler was the major contributor to manuscript preparation, with assistance from the other authors.

Findings show that targeted outreach by trained pharmacy advocates can identify vulnerable Medicare populations in need of Part D counseling and reduce their expected annual OOP prescription drug costs.

ConTeMPoRARyS uBJeCTpayment from the health plan was$1per member per month (PMPM), or $57,024 if the total incentive P4P payment was$2PMPM.COnClusiOns: Preliminarydata from 165 patients with diabetes managed in aCDCM programinamedical group operating under asmall P4P financial incentive showed higher rates of lDl-C lab testing and goal attainment than from patients managed by routine care. Had these rates of lDl-C testing and goal attainment achieved in the CDCM programbeen extended to the entire P4P population with diabetes, this medical group would have generated incentive payments under the P4P programand ranked higher in publicly available quality scores. What is already known about this subject•P ay for Performance (P4P) programs alone have not been shown to improve quality of care.•C hronic disease caremanagement (CDCM) programs have reportedly attained high rates of low-density lipoprotein cholesterol (LDL-C) testing (96.7%-97.3%) and goal LDL-C <100 mg per dL (56.5%-83.3%) for patients with diabetes, but the study methods have lacked patient randomization. What this study adds•T his is the first study to show the potential impact that CDCM may have on the P4P rankings and financial payouts for amedical group. P ay for performance (P4P) is ab usiness model by which health plans pay provider organizations (medical groups) for consistently demonstrating high levels of quality performance based on established criteria. 1-4The results of the P4P clinical measures arep ublicly available and areo ften discussed during contract negotiations between medical groups and health plans. California has the largest and most comprehensive P4P program; however,P 4P programs exist nationwide. [1][2][3][4][5][6] In fact, ar ecent survey demonstrated that most health plans that offer commercial health maintenance organization (HMO) products BaCKGROunD: Pay for performance (P4P) is abusiness model in whichhealth plans pay provider organizations (medical groups) financial incentives based on attainment of clinical quality,patient experience,and use of information technology.The California P4P programisthe largest P4P programinthe united states and represents apotential revenue source for all participating medical groups. The clinical specifications for the California P4P programare based on the national Committee for Quality assurance (nCQa), Health Plan EmployerData, and information set (HEDis), and eachclinical measurehas its ownbenchmark. in 2005, participating medical groups werepaid on the basis of 9clinical measures that wereevaluated in the 2004 measurement year. The cholesterol testing measurerepresented 4.44%-7.14% of the total P4P dollars available to participating medical groups from the health plans.

Objective. To incorporate a pharmacy informatics program in the didactic curriculum of a team-based learning institution and to assess students' knowledge of and confidence with health informatics during the course. Design. A previously developed online pharmacy informatics course was adapted and implemented into a team-based learning (TBL) 3-credit-hour drug information course for doctor of pharmacy (PharmD) students in their second didactic year. During a period of five weeks (15 contact hours), students used the online pharmacy informatics modules as part of their readiness assurance process. Additional material was developed to comply with the TBL principles. Online pre/postsurveys were administered to evaluate knowledge gained and students' perceptions of the informatics program. Assessment. Eighty-three second-year students (84% response rate) completed the surveys. Participants' knowledge of electronic health records, computerized physician order entry, pharmacy information systems, and clinical decision support was significantly improved. Additionally, their confidence significantly improved in terms of describing health informatics terminology, describing the benefits and barriers of using health information technology, and understanding reasons for systematically processing health information. Conclusion. Students responded favorably to the incorporation of pharmacy informatics content into a drug information course using a TBL approach. Students met the learning objectives of seven thematic areas and had positive attitudes toward the course after its completion.

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