A Migraine Prophylaxis Educational Intervention in a Medicaid Population

Abstract

Following an educational intervention for Idaho Medicaid patients identified through retrospective DUR, a trial of a migraine prophylactic drug was initiated for approximately one-third of potential candidates.

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

“…5,28,29,32 Additionally, each of the 4 programs that provided educational materials alone were found to have little to no impact on measured outcomes. 24,44,50,51 It should be noted that one program that reported positive outcomes used prescriber feedback in combination with patientidentifying data and educational material. 23 Along with providing educational material for prescribers, several programs also included supplemental educational material for patients.…”

“…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.…”

“…With the exception of 2 programs, the authors concurred with individual program interpretation of impact on prescribing patterns ( 24 Though the intervention conducted by Owens et al was associated with an increase use of prophylactic therapy, this study relied heavily on surrogate markers and assumptions regarding the indicated use of target agents and was classified as questionable impact for the purpose of this review. 50 Starner et al found their intervention to be associated with a significant decrease in target agent use; however, this was determined according to prescriptions claims data obtained on a single day 6 months post-intervention. This method was relatively restrictive (as compared with that employed by other programs) and therefore may not be representative of actual prescribing patterns.…”

“…In addition to measuring effect on prescribing patterns, 5 programs also evaluated intervention impact on number of office visits, emergency room visits, and hospitalizations (Table 2). 8,10,11,22,50 None of the programs noted changes in emergency room visits or hospitalizations. Increased office visits were observed by and Owens et al, while noted decreased office visits and use of physician services among both intervention and comparison groups.…”

“…Increased office visits were observed by and Owens et al, while noted decreased office visits and use of physician services among both intervention and comparison groups. 8,22,50 Economic Impact. Table 4 displays the association between mailed intervention and change in economic outcomes.…”