Retrospective drug utilization review and the behavior of medicaid prescribers: an empirical marginal analysis

Improving the Success of Mailed Letter Intervention Programs to Influence Prescribing Behaviors: A Review

“…[2][3][4][5][6][7] In addition to promoting safe and effective therapy, retrospective drug utilization review can also be used to coordinate care among physicians, reduce medication costs, and promote changes in prescribing behavior to reflect evidence-based recommendations. [8][9][10][11][12] Medication-related concerns identified during retrospective drug utilization reviews may be communicated to prescribers using mailed intervention letters. Materials contained in intervention packets vary among programs, often according to targeted outcomes and/or availability of data, and may include patient-identifying data, prescriber feedback, educational information, and supplemental patient education materials.…”

“…Twenty-one of the 25 programs that provided some form of patient-identifying data were considered to have a significant impact on prescribing. [2][3][4][7][8][9][10][11][12][13][14][15][16][18][19][20][21][22][23]25,48 It should be noted that Meyer et al considered their patient-identifying intervention to be unsuccessful because changes in prescribing patterns were no longer significant at 6 and 12 months postintervention.…”

“…49 Most programs that used patient-identifying data opted to make generalized recommendations that could be applicable to their entire target population. [2][3][4][7][8][9][10][11][12][13][14]16,[18][19][20][21][22][23][24][25]48,49 For example, the intervention conducted by alerted physicians of the identified patient's potential for acetaminophen overuse, discussed the associated risks, and suggested adjusting therapy to meet recommended daily standards. 12 Such a method appears to be an effective intervention tactic, as 20 of 22 programs (90.1%) that provided this type of recommendation were successful.…”

“…Act (HIPAA) [2][3][4][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] ; provision of such information is uncommon among programs conducted overseas. Programs outside of the United States commonly use prescriber feedback alone or in combination with educational materials to encourage changes in prescribing practices.…”

“…Response rate among reporting programs ranged from 25% to nearly 90%. 2,9,10,12,14,18,20,21,27,29,32,46,[48][49][50] Generally, recipients viewed the intervention positively and often indicated intent to alter therapy based on the materials received. The majority of programs that reassessed patient profiles following response from mailings reported that an actual change in therapy occurred in approximately 50% of patients whose prescriber indicated intent to modify treatment.…”