A pharmacoeconomics and formulary management collaborative project to teach decision analysis principles.

Objective: To implement and assess the effectiveness of a 2-course collaborative decision analysis project intended to help students understand the relevance of pharmacoeconomics to clinical pharmacy practice and provide them an opportunity to apply skills taught in pharmacoeconomics to a "real world" problem.

Design: Students were assigned a pair of drugs, 1 commonly used as standard therapy and 1 newly approved, and conducted a decision analysis. The results were then used in a mock pharmacy and therapeutics (P&T) committee meeting.

Community physician education in geriatrics: applying the assessing care of vulnerable elders model with a multisite primary care group.

Providing practicing physicians with effective education that leads to better patient outcomes remains challenging. In 2003, the University of Cincinnati College of Medicine developed a comprehensive program to enhance practicing physician geriatric medicine education based on the Assessing the Care of Vulnerable Elders model. The program was implemented with a large, multisite primary care group based in the greater Cincinnati area and was designed to increase physicians' clinical skills and assist them in implementing new office and system strategies that could improve the quality of care for their older patients.

Analysis of the effectiveness and cost benefit of leukotriene modifiers in adults with asthma in the Ohio Medicaid population.

Objective: The objectives of this research were to (1) determine the association of the use of leukotriene modifiers (LMs) with 3 clinical outcome measures that can serve as proxy measures of effectiveness: subsequent emergency room visits, hospitalizations, and steroid bursts, and (2) estimate whether LM use compared with nonuse is cost beneficial from a Medicaid payer perspective.

Methods: This was a retrospective, longitudinal study of asthma patients in the fee-for-service Ohio Medicaid program. The study population included 5,541 adult patients who were identified as having a claim containing an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for asthma (code 493.

Acute pancreatitis associated with different combination therapies in patients infected with human immunodeficiency virus.

Study Objective: To assess the risk of acute pancreatitis in patients receiving various combinations of protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs), and nonnucleoside reverse transcriptase inhibitors (NNRTIs) for treatment of human immunodeficiency virus (HIV) infection.

Design: Retrospective cohort study.

Data Source: Ohio Medicaid claims database, January 1997-December 2002.

Impact of regulatory labeling for troglitazone and rosiglitazone on hepatic enzyme monitoring compliance: findings from the state of Ohio medicaid program.

Purpose: Troglitazone, the first drug of the thiazolidinediones class for type II diabetes, was first marketed in March 1997 and was removed from the U.S. market 36 months later after 90 cases of liver failure were reported despite multiple warnings containing liver enzyme monitoring recommendations.

Characteristics and risk factors associated with high-cost Medicaid recipients.

Characteristics and risk factors of fee-for-service Medicaid patients (age < 65 yr) with high health care costs were assessed by analyzing Ohio's Medicaid claims database. High-cost recipients were defined as those with average monthly Medicaid expenses at or above the 90th percentile. The records of 10,582 high-cost patients and 11,045 comparison patients were examined for clinical comorbidity, mortality status, enrollment, and demographic factors, using logistic and logarithmic multiple regression.

Beta-blocker underuse in secondary prevention of myocardial infarction.

Objective: To review the clinical benefits of beta-blockers as secondary prevention following a myocardial infarction (MI) and to address the reasons that clinicians are reluctant to use beta-blockers in specific patient populations.

Data Sources: MEDLINE was searched for articles published from January 1966 to October 2002. Relevant studies were identified by systematic searches of the literature for all reported studies of associations between beta-blocker underuse and secondary prevention of MI.

Acetaminophen overuse in the Ohio Medicaid population.

Objective: To examine patterns of use of acetaminophen in patients with and without risk factors for hepatotoxicity in the Ohio Medicaid population.

Design: Retrospective, cross-sectional analysis of claims data.

Setting: Ohio.

Predictors of warfarin use among Ohio medicaid patients with new-onset nonvalvular atrial fibrillation.

Background: Despite demonstrated efficacy in stroke prevention, warfarin is underused in patients with atrial fibrillation (AF). Reasons for warfarin nonuse are unclear.

Methods: We conducted a retrospective cohort analysis using Ohio Medicaid administrative billing data to ascertain determinants of warfarin use for patients with new-onset nonvalvular AF.

Relationship between asthma drug therapy patterns and healthcare utilization.

Background And Objective: Asthma drug therapy problems contribute significantly to preventable hospitalizations and increased healthcare use in asthmatics. Since asthma patients often require >1 medication for control of symptoms, concurrent asthma drug therapies may be important in predicting excessive healthcare utilization. The purpose of this study was to link inappropriate asthma drug therapy patterns and selected patient demographics to healthcare utilization.