208450 Assessing the Value to Practitioners of the UMWA Health and Retirement Funds' MineRx Program

Sunday, November 8, 2009

M. Paige Powell, PhD , Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Eric P. Jack, PhD , School of Business, University of Alabama at Birmingham, Birmingham, AL
Jeroan J. Allison, MD, MPH , Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Kenneth G. Saag, MD , Division of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL
Hugh Tilson, MD, DrPH , School of Public Health, University of North Carolina, Chapel Hill, NC
Patrick Irvine, MD , UMWA Health and Retirement Funds, Washington, DC
William H. Campbell, PhD , Health Policy and Management, University of North Carolina, Chapel Hill, NC
Joel Kavet, MPH, ScD , UMWA Health and Retirement Funds, Washington, DC
Norman W. Weissman, PhD , Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Program: The UMWA Health and Retirement Funds developed the MineRx Program to support primary care physicians (PCPs) in their efforts to enhance the quality and effectiveness of drug therapy provided to frail elderly patients. The core of the Program is a Patient Medication List (PML) delivered quarterly to participating practitioners for each Funds beneficiary in their practice. The PML apprises the PCP of every medication prescription filled for the beneficiary in the preceding four months, including the identity of the prescriber. The Program developed and provided to participating PCPs a list of 26 Target Drugs and Drug Patterns (TDP List) known to pose risks for the elderly. The TDP List is complemented by a TDP Handbook, which describes the TDPs and offers strategies for managing the risks associated with these medications. A Drug Resource Center is available to PCPs as a resource for drug-specific information and consultations or as a portal for referring patients into a care coordination program addressing medication-related issues.

Methods: We designed, pilot-tested, and administered a 10 question survey, using a 7-point Likert-type scale, to all clinical providers participating in the Program (n=496). We received 217 completed surveys (43.8% response rate). The survey asked practitioners to evaluate the Program and its resources relative to other PBMs' programs, publicly available materials and resources, and local pharmacists' drug safety monitoring and consultation. We also assessed practitioners' awareness of the risks associated with a list of specific drugs and drug combinations compared to non-listed drugs using clinical vignettes.

Results: Providers rated the PML as a significantly more valuable resource than other PBM programs' resources (mean=5.19 vs. 4.34, p<.0001). The identification of high risk drugs and drug patterns and the fact that the PML lists all prescribers were the aspects of the PML most valued by respondents (mean=5.44 and 5.40, respectively). Program resources were rated significantly higher in value than Medication or Pharmaceutical Websites and Targeted Health Education Websites (mean=4.98 vs. 3.40 and 4.35, p<.0001). Practitioners rated their level of concern significantly higher for TDP-related risks than for non-TDP related risks (various drugs and related adverse events: mean=5.94 vs. 4.20, p<.0001; warfarin and other drugs with potential for interaction: (mean=5.23 vs. 4.49, p<.0001).

Conclusions: The MineRx Program, particularly the PML content and information, is a valuable resource to practitioners in reducing or managing the risks associated with use of medications by the elderly, especially compared to other pharmacy benefit management programs.

Learning Objectives:
To assess providersí perceptions of the value of the MineRx Program, an innovative feature of the Fundsí pharmacy benefit management program.

Keywords: Frail Elderly, Drug Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD from Penn State in Health Policy and Administration and was co-PI for this evaluation project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.