Medication-use evaluation with a Web application

Abstract

The MUET application has enabled the increased standardization of medication safety initiatives across the VA system and may serve as a useful model for the development of pharmacovigilance tools by other large integrated health care systems.

Preventing Hepatitis B Reactivation During Anti‐CD20 Antibody Treatment in the Veterans Health Administration

“…A) and provided feedback to the majority of sites that volunteered to participate. ( ) We observed that 40%‐50% of all identified patients receiving anti‐CD20 Ab treatment in June to August 2016 did not have pretreatment HBV testing completed. Among patients with chronic or prior HBV requiring HBV antiviral prophylaxis, up to 40% of patients did not receive antiviral prophylaxis within 1 month of initiating anti‐CD20 Ab therapy.…”

“…This analysis is limited by use of observational data, which do not prove causality. Earlier demonstrated to enhance laboratory testing and safe VHA medication use, ( ) the MUET currently identifies omissions of HBV testing and antiviral prophylaxis among all those identified as initiating anti‐CD20 Ab therapy and provides voluntary feedback to sites. As pretreatment HBV testing remains incomplete, our analyses required use of an estimation of 11% of patients with chronic or prior HBV (as observed in an earlier national VHA analysis ( ) ) to determine rates of HBV antiviral prophylaxis; the true numbers may differ slightly.…”

“…MUET is a risk‐reduction tool that uses medication and laboratory data to identify at‐risk patients receiving specific medications that pose potential safety risks. ( ) The MUET provided national monthly data on our two primary analyses: 1) HBV testing within 12 months of starting anti‐CD20 Ab treatment and 2) HBV antiviral medication in patients with chronic or prior HBV, within 1 month of starting anti‐CD20 Ab treatment.…”

“…At participating VAMCs, HBV testing and antiviral treatment interventions were documented for each at‐risk patient. ( )…”

Pharmacy Benefits Management in the Veterans Health Administration Revisited: A Decade of Advancements, 2004-2014

“…MUET is a web-based application that provides VA medical centers with secured lists of target patients that meet pre-set criteria for intervention and enables the interventions to be "reported back" into a centralized database. 9 As examples, use of MUET improved prescribing of erythropoiesis-stimulating agents and enhanced compliance with the direct oral anticoagulant CFU. Risk reduction projects employ a variety of methods to improve medication use.…”