Optimizing Drug Prescribing in Managed Care Populations

摘要: Managed care presents interesting opportunities to optimize clinical and economic outcomes related drug prescribing. There are very few randomized controlled trials that have evaluated methods educate or incentivize physicians, implement formulary management guideline tools, profile pharmacist interventions ensure optimal Single of optimizing medication not been shown be as effective multifaceted approaches. Specific reinforcement the message at time prescribing has improve antibiotic in patients with chronic bronchitis adherence treatment guidelines for following myocardial infarction. Results from a trial showed changes pharmacy benefit design decreased costs utilization. Much literature evaluating effectiveness utilization techniques therapy is retrospective nature. However, intervention reduce polypharmacy elderly. Appropriate scores were improved this improvement was sustained 12 months post intervention. Clinical services hospital admission days, decrease prescription total health costs, number drugs per patient, attainment target low density lipoprotein cholesterol values. Recent analyses there higher likelihood achieving when three more aspects healthcare impacted: patient self-management, information availability, redesign way delivered, decision support strategies, system, provider organization. In review designed illnesses, process variables one two improved. Outcome four impacted. continues great focus on improving quality managed environments. With passing Medicare legislation US, by 2006 vast majority citizens will receive Additional research explore needed characterize most efficient, transparent, least costly ways misuse, overuse, underuse drugs.