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years). Seven out of the 9 patient were under the care of at least two physicians. Dyslipidemia, hypertension and diabetes are the main condition affecting the participants (100%, 88.9%, 66.7%, respectively). A total of 12 DRP were detected: underuse of medication (nϭ7, of which 2 were due to non-compliance), overuse of medication (nϭ1), incorrect timing (nϭ2) and therapy failure (nϭ2). Pharmacists spent an average 3.5 hours per home visit. Total programme cost was $787.5 (9 visits x $25/hr x 3.5hr/ visit). Hence, cost per DRP detected was estimated at $65.63. One of the DRP detected was vertigo without treatment. Hence, programme cost may be potentially offset by the savings from avoiding an episode of hospitalization due to fall. CONCLUSIONS: DRP is prevalent and potentially preventable but were undetected in this primary care sample. Hence, there is a role for HBMR. We are currently conducting a longitudinal randomized controlled trial to evaluate the cost-effectiveness of providing and not providing HBMR by collecting direct and indirect costs, health services utilization and health-related quality of life outcomes at baseline and 6-months.

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termination. CONCLUSIONS: Clinical trial learning curves have significant implications for outcomes research accuracy, patient safety, and overall trial success. Clinical trial simulation may provide a broadly applicable methodology for addressing several factors associated with clinical trial learning curve effects and for improving the accuracy of clinical trial outcomes. OBJECTIVES:Recent developments in the United States (US) health care reform and funding for comparative effectiveness research suggest that use of electronic medical records (EMR) in outcomes research may increase over time. EMR can be particularly useful when outcomes are not well-defined with diagnosis or procedures codes or when clinical data are needed. The objective of this study was to review trends in the use of EMR during the past decade. METHODS: A review of published literature was conducted in PubMed for years 2001 through 2010 to identify outcomes studies in the US that used EMR. Internal quality assurance studies and validation studies that used EMR were excluded. The number of studies, setting of care, patient population, whether the study was comparative, and any noted limitations were examined. RESULTS: A total of 58 EMR-based, outcomes studies in the US were identified over the past decade; increasing from 3 in 2001 to 12 in 2010. The majority of studies included outpatient EMR. Studies included a variety of patient populations with over one-third in cardiovascular disease, psychiatric disease, and diabetes combined. The percent of studies that were comparative ranged from 0% in 2001 to 45% in 2010. Measures of effectiveness varied widely and included lab values, clinical measures, and health-related quality-of-life outcomes. Some noted limitations on the use of EMR data in outcomes research included lack of representativeness of all care delivered across practice settings, lack of generalizability and standardization, and reliance on health care provider reporting. CONCLUSIONS: Although the use of EMR in outcomes research has increased slowly in the past decade, the proportion of comparative studies using EMR has increased over time. As the industry works to standardize EMR and more advanced outcomes are collected in EMR systems, EMR data may play a larger role in comparative effectiveness research.