Electronic Notifications about Drug Substitutes Can Change Physician Prescription Habits

Zuker, Allon; Heart, Tsipi; Parmet, Yisrael; Pliskin, Nava; Pliskin, Joseph S.

doi:10.1177/0272989x10385848

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…However, there may be indirect benefits to patients if lower total drug costs for insurers lead to fewer premium increases. Our study used a simple website to provide such drug cost information, but our results support findings from the limited number of larger scale studies examining the integration of formularies and drug costs into e-prescribing [ 18 – 21 ]. Fischer’s study of e-prescribing with formulary support for 1.5 million patients estimated total drug cost savings of $845,000 per 100,000 patients assuming a 20 % uptake among their providers [ 18 ].…”

Section: Discussionsupporting

confidence: 77%

“…McMullin’s study of 38 primary care providers with half receiving e-prescribing with clinical decision support (including preferred drug options) estimated total drug cost savings at $1.07 per member per month (~$1.2 million per 100,000 patients) [ 19 , 20 ]. Zuker’s study of 647 providers and e-prescribing with formulary support estimated total drug cost savings of 4 % [ 21 ]. These studies did not report whether giving formulary information reduced out-of-pocket costs or increased medication use.…”

Section: Discussionmentioning

confidence: 99%

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Giving formulary and drug cost information to providers and impact on medication cost and use: a longitudinal non-randomized study

Tseng

Lin

Davis

et al. 2016

BMC Health Serv Res

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BackgroundProviders wish to help patients with prescription costs but often lack drug cost information. We examined whether giving providers formulary and drug cost information was associated with changes in their diabetes patients’ drug costs and use. We conducted a longitudinal non-randomized evaluation of the web-based Prescribing Guide (www.PrescribingGuide.com), a free resource available to Hawaii’s providers since 2006, which summarizes the formularies and copayments of six health plans for drugs to treat 16 common health conditions. All adult primary care physicians in Hawaii were offered the Prescribing Guide, and providers who enrolled received a link to the website and regular hardcopy updates.MethodsWe analyzed prescription claims from a large health plan in Hawaii for 5,883 members with diabetes from 2007 (baseline) to 2009 (follow-up). Patients were linked to 299 “main prescribing” providers, who on average, accounted for >88 % of patients’ prescriptions and drug costs. We compared changes in drug costs and use for “study” patients whose main provider enrolled to receive the Prescribing Guide, versus “control” patients whose main provider did not enroll to receive the Prescribing Guide.ResultsIn multivariate analyses controlling for provider specialty and clustering of patients by providers, both patient groups experienced similar increases in number of prescriptions (+3.2 vs. +2.7 increase, p = 0.24), and days supply of medications (+141 vs. +129 increase, p = 0.40) averaged across all drugs. Total and out-of-pocket drug costs also increased for both control and study patients. However, control patients showed higher increases in yearly total drug costs of $208 per patient (+$792 vs. +$584 increase, p = 0.02) and in 30-day supply costs (+$9.40 vs. +$6.08 increase, p = 0.03). Both groups experienced similar changes in yearly out-of-pocket costs (+$41 vs + $31 increase, p = 0.36) and per 30-day supply (−$0.23 vs. −$0.19 decrease, p = 0.996).ConclusionGiving formulary and drug cost information to providers was associated with lower increases in total drug costs but not with lower out-of-pocket costs or greater medication use. Insurers and health information technology businesses should continue to increase providers’ access to formulary and drug cost information at the point of care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1752-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Giving formulary and drug cost information to providers and impact on medication cost and use: a longitudinal non-randomized study

Tseng

Lin

Davis

et al. 2016

BMC Health Serv Res

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The prescription of lidocaine patches in osteoarthritis—a complete audit cycle

et al. 2018

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Probabilistic Priority Assessment of Nurse Calls

et al. 2014

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Current nurse call systems are very static. Call buttons are fixed to the wall, and systems do not account for various factors specific to a situation. We have developed a software platform, the ontology-based Nurse Call System (oNCS), which supports the transition to mobile and wireless nurse call buttons and uses an intelligent algorithm to address nurse calls. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff and patients into account by using an ontology. This article describes a probabilistic extension of the oNCS that supports a more sophisticated nurse call algorithm by dynamically assigning priorities to calls based on the risk factors of the patient and the kind of call. The probabilistic oNCS is evaluated through implementation of a prototype and simulations, based on a detailed dataset obtained from 3 nursing departments of Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls among nurses, and the assignment of priorities to calls are compared for the oNCS and the current nurse call system. Additionally, the performance of the system and the parameters of the priority assignment algorithm are explored. The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the probabilistic oNCS significantly improves the assignment of nurses to calls. Calls generally result in a nurse being present more quickly, the workload distribution among the nurses improves, and the priorities and kinds of calls are taken into account.

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Electronic Notifications about Drug Substitutes Can Change Physician Prescription Habits

Cited by 3 publications

References 22 publications

Giving formulary and drug cost information to providers and impact on medication cost and use: a longitudinal non-randomized study

Giving formulary and drug cost information to providers and impact on medication cost and use: a longitudinal non-randomized study

The prescription of lidocaine patches in osteoarthritis—a complete audit cycle

Probabilistic Priority Assessment of Nurse Calls

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