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Principles of educational outreach ('academic detailing') to improve clinical decision making.
Using the theory and practice of methods to improve physicians' clinical decision making to enhance the quality and cost-effectiveness of care and to reduce inappropriate prescribing as well as unnecessary health care expenditures are shown.
Patients At-Risk for Cost-Related Medication Nonadherence: A Review of the Literature
Older patients with chronic diseases and mood disorders are at-risk for CRN even if enrolled in Medicare’s new drug benefit, and efforts to reduce cost-related medication nonadherence would benefit from greater study of factors besides the presence of prescription drug coverage.
Coverage by the news media of the benefits and risks of medications.
News-media stories about medications may include inadequate or incomplete information about the benefits, risks, and costs of the drugs as well as the financial ties between study groups or experts and pharmaceutical manufacturers.
Improving drug-therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing".
Physicians who were offered personal educational visits by clinical pharmacists along with a series of mailed "unadvertisements" reduced their prescribing of the target drugs by 14 per cent as compared with controls, resulting in substantial cost savings.
Cost-related medication nonadherence and spending on basic needs following implementation of Medicare Part D.
There was evidence for a small but significant overall decrease in CRN and forgoing basic needs following Part D implementation, and no net decrease inCRN after Part D was observed among the sickest beneficiaries, who continued to experience higher rates of CRN.
Cost-related medication nonadherence among elderly and disabled medicare beneficiaries: a national survey 1 year before the medicare drug benefit.
Rates are highest among nonelderly disabled beneficiaries, but among both elderly and disabled beneficiaries), CRN is exacerbated by poor health, multiple morbidities, and limited drug coverage.
Potential Bias of Instrumental Variable Analyses for Observational Comparative Effectiveness Research
- Laura F. Garabedian, P. Chu, S. Toh, A. Zaslavsky, S. Soumerai
- Economics, MedicineAnnals of Internal Medicine
- 15 July 2014
Instrumental variable analysis is an increasingly popular method to establish causal conclusions from observational comparative effectiveness research (CER) studies, and there is a consensus that more research on the validity of instruments in observational CER is needed.
Improved therapeutic monitoring with several interventions: a randomized trial.
All 3 interventions were effective in increasing laboratory monitoring when initiating new medications in primary care, and further work is necessary to determine if these interventions improve patient outcomes.
Systematic Review: The Relationship between Clinical Experience and Quality of Health Care
The robustness of the relationship between clinical experience and quality of care is assessed by systematically reviewing empirical studies to assess the effects of experience on the quality of medical care.
Delayed Hospital Presentation in Patients Who Have Had Acute Myocardial Infarction
The identification of factors contributing to delayed hospital presentation in patients who have had acute myocardial infarction is essential to the development of appropriate patient-directed educational interventions to reduce delay.