Changes in long-acting β-agonist utilization after the FDA's 2010 drug safety communication.

Purpose: In February 2010, the US Food and Drug Administration (FDA) issued new recommendations for the safe use of long-acting β-agonists (LABAs) in patients with asthma. The objective of this study was to determine the impact of the FDA's 2010 safety advisory on LABA utilization.

Methods: Using administrative data from the Oregon Medicaid program, we performed an interrupted time series regression to evaluate changes in the trend in new LABA prescriptions before and after the FDA's 2010 advisory.

Antimicrobial prescribing for upper respiratory infections and its effect on return visits.

Background And Objectives: Antibiotic resistance is a growing problem that complicates the treatment of various illnesses. This study analyzes Medicaid encounter data to (1) determine antibiotic prescribing rates for common respiratory tract infections in Oregon and (2) assess the effect of receiving an antibiotic at an index visit on whether there was a return visit within 30 days.

Methods: Subjects included in this study were Medicaid patients in Oregon between 2001--2003 who were enrolled in Medicaid for a full year and were diagnosed with an upper respiratory tract infection, including bronchitis, sinusitis, acute otitis media (AOM), pharyngitis, and upper respiratory infections (URIs).

Impact of a Medicaid copayment policy on prescription drug and health services utilization in a fee-for-service Medicaid population.

Background: Copayments (copays) for prescription drugs are a common policy among state Medicaid programs. Research exploring the effects of copays on pharmacy and health care utilization in Medicaid patients is limited, especially among patients with chronic disease.

Objectives: The goal of this research was to quantify the impact of a copay policy for prescription drugs on medication and health services utilization overall and among subjects with several common chronic diseases enrolled in a state Medicaid program.

Improving outpatient warfarin use for hospitalized patients with atrial fibrillation.

Unlabelled: Atrial fibrillation affects an estimated 5 million Americans and accounts for approximately 15% of all strokes. Few studies have successfully addressed patient screening, assessment, and introduction of appropriate antithrombotic therapy in patients with atrial fibrillation.

Objective: To assess whether an intervention improved planned antithrombotic prescribing at the time of discharge in hospitalized patients.

Rates of adverse events of long-acting opioids in a state Medicaid program.

Background: Despite widespread use and emerging safety concerns, data on the comparative safety and effectiveness of long-acting opioid (LAO) analgesics are weak.

Objective: To compare rates of adverse events among patients newly prescribed an LAO.

Methods: A retrospective observational cohort study using Medicaid administrative claims data was conducted examining time until first adverse outcome among patients with new prescriptions for methadone, extended-release (ER) oxycodone, ER morphine, or transdermal fentanyl.

An evaluation of Oregon's evidence-based Practitioner-Managed Prescription Drug Plan.

This paper describes Oregon's implementation of its publicly developed, evidence-based, Practitioner-Managed Prescription Drug Plan (PMPDP). Oregon's PMPDP was initially self-enforced with a dispense as written (DAW) exception process, followed by an educational prior authorization (soft PA) method, and finally no active enforcement. Market-share trends indicate that the educational prior authorization process was most effective at increasing the use of preferred agents.

Initial results of the use of prescription order change forms to achieve dose form optimization (consolidation and tablet splitting) of SSRI antidepressants in a state Medicaid program.

Background: One method to reduce drug costs is to promote dose form optimization strategies that take advantage of the flat pricing of some drugs, i.e., the same or nearly the same price for a 100 mg tablet and a 50 mg tablet of the same drug.

Effects of a prior-authorization policy for celecoxib on medical service and prescription drug use in a managed care Medicaid population.

Background: Prior authorization (PA) is a poorly studied but commonly employed policy used by health care payers to manage the rising costs of pharmacy benefits.

Objective: The aim of this study was to evaluate the intended and unintended effects of a PA policy for celecoxib on pharmacy and medical-service utilization in a Medicaid managed-care organization.

Methods: This was a retrospective, interrupted time-series analysis of 22 monthly health-related utilization rates from January 1, 1999, to October 31, 2000.

Gabapentin use in a managed medicaid population.

Objective: The use of gabapentin, an antiepileptic agent, in a primary care setting was evaluated to determine (a) the conditions being treated, (b) specialties of the prescribers, (c) dose ranges, and (d) the extent of documentation and follow-up.

Methods: A retrospective review of both claims data and patient charts was performed by a clinical pharmacist. Patients were identified from CareOregon and Oregon Medicaid fee-for-service drug claim databases.