Evaluation of a Physician-Focused Educational Intervention on Medicaid Children with Asthma

Abstract

Although the physician responders agreed on the usefulness of the educational materials, the results suggest that the intervention had limited success in improving the pharmacologic management and no effect on the health outcomes. We believe that mailed educational materials to physicians can be effective to change prescribing behavior; however, a more multifaceted intervention may be necessary to improve health outcomes.

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.…”

“…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.…”

“…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.…”

A review of strategies to improve rational prescribing in asthma

“…Lee et al studied the impact of providing a review of individual patient medications in addition to educational material: although there was a drop in SABA use from 300 to 200 puffs per month, there was no change in clinical outcomes as measured by emergency visits and asthma related hospitalisation. 11 Technology can facilitate the individualisation of prescribing advice, as education can be integrated with electronic health records. Cho et al described such as program that reduced the use of SABAs and systemic steroids and increased preventer medication use.…”