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Evaluation of physician intervention letters
K L Rascati1, G J Okano, C Burch
1University of Texas College of Pharmacy, Austin 78712-1074, USA.
Medical Care
|August 1, 1996
Summary
Intervention letters effectively reduced duplicate anti-ulcer medication prescriptions among Texas Medicaid patients. This drug utilization review strategy shows promise for improving prescribing practices.
Area of Science:
- Health Services Research
- Pharmacoeconomics
- Public Health Policy
Background:
- The Omnibus Budget Reconciliation Act of 1990 mandates drug utilization review (DUR) for Medicaid agencies.
- Texas Medicaid implemented intervention letters to address potential medication misuse, focusing on duplicative anti-ulcer drugs.
Purpose of the Study:
- To evaluate the impact of intervention letters on physicians prescribing duplicative anti-ulcer medications.
- To assess the effectiveness of mail-based physician interventions in modifying prescribing behavior.
Main Methods:
- A randomized controlled trial analyzed 335 Medicaid patient profiles with concurrent anti-ulcer therapy.
- Physicians for 174 patients received intervention letters; the remainder formed a control group.
Main Results:
- A 71.2% response rate to intervention letters was achieved, with 48.9% agreement.
- Six months post-intervention, duplicative therapy decreased significantly in the intervention group (47.7%) compared to the control group (64.4%).
Conclusions:
- Intervention letters demonstrated a statistically significant reduction in duplicative anti-ulcer prescribing.
- This study supports intervention letters as an effective tool for changing physician prescribing habits, warranting further research into other drug classes and patient outcomes.