Impact of an educational intervention for secondary prevention of myocardial infarction on Medicaid drug use and cost

Ilene H. Zuckerman, Sheila R. Weiss, Diane McNally, Barbara Layne, C. Daniel Mullins, Junling Wang

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Objectives: The objectives of this drug utilization review program were (1) to increase β-blocker prescribing to fee-for-service post-acute myocardial infarction (AMI) Medicaid patients; (2) to improve compliance among patients who were prescribed β-blockers post-AMI; and (3) to evaluate the economic implications of increased β-blocker prescribing. Study Design: Pre-post nonequivalent group design. Patients and Methods: The intervention targeted physicians of Pennsylvania Medicaid recipients who had an AMI between November 1, 1998, and November 1, 1999. Educational materials were sent to the physicians of post-AMI patients not receiving β-blockers. Preintervention and postintervention rates of β-blocker prescribing in the Medicaid program within 7 and 30 days of discharge after an AMI hospitalization were compared. Similarly, pre- and postintervention compliance rates were compared for AMI patients who were prescribed β-blockers. Cost savings and number of avoided deaths also were calculated. Results: There was a 5.5% to 6.9% increase in β-blocker prescribing after the intervention, depending on the follow-up period. Postintervention AMI patients were 16% more likely to be prescribed a β-blocker. There was an 8.3% increase in patient compliance with β-blocker therapy from preintervention to postintervention. In the first 2 years of the intervention, the estimated cost savings to the Pennsylvania Medicaid program ranged from $71 970 to $76 678, respectively. An estimated 3 deaths were avoided. Conclusions: The intervention resulted in increased appropriate prescribing and compliance with β-blockers among post-AMI patients. There also were estimated cost savings to Pennsylvania Medicaid as a result of reduced hospitalization, and fewer deaths.

Original languageEnglish (US)
Pages (from-to)493-500
Number of pages8
JournalAmerican Journal of Managed Care
Volume10
Issue number7 II
StatePublished - Jul 1 2004

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Drug Costs
Medicaid
Secondary Prevention
Myocardial Infarction
Cost Savings
Patient Compliance
Hospitalization
Drug Utilization Review
Physicians
Fee-for-Service Plans
Economics

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Impact of an educational intervention for secondary prevention of myocardial infarction on Medicaid drug use and cost. / Zuckerman, Ilene H.; Weiss, Sheila R.; McNally, Diane; Layne, Barbara; Mullins, C. Daniel; Wang, Junling.

In: American Journal of Managed Care, Vol. 10, No. 7 II, 01.07.2004, p. 493-500.

Research output: Contribution to journalReview article

Zuckerman, Ilene H. ; Weiss, Sheila R. ; McNally, Diane ; Layne, Barbara ; Mullins, C. Daniel ; Wang, Junling. / Impact of an educational intervention for secondary prevention of myocardial infarction on Medicaid drug use and cost. In: American Journal of Managed Care. 2004 ; Vol. 10, No. 7 II. pp. 493-500.
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abstract = "Objectives: The objectives of this drug utilization review program were (1) to increase β-blocker prescribing to fee-for-service post-acute myocardial infarction (AMI) Medicaid patients; (2) to improve compliance among patients who were prescribed β-blockers post-AMI; and (3) to evaluate the economic implications of increased β-blocker prescribing. Study Design: Pre-post nonequivalent group design. Patients and Methods: The intervention targeted physicians of Pennsylvania Medicaid recipients who had an AMI between November 1, 1998, and November 1, 1999. Educational materials were sent to the physicians of post-AMI patients not receiving β-blockers. Preintervention and postintervention rates of β-blocker prescribing in the Medicaid program within 7 and 30 days of discharge after an AMI hospitalization were compared. Similarly, pre- and postintervention compliance rates were compared for AMI patients who were prescribed β-blockers. Cost savings and number of avoided deaths also were calculated. Results: There was a 5.5{\%} to 6.9{\%} increase in β-blocker prescribing after the intervention, depending on the follow-up period. Postintervention AMI patients were 16{\%} more likely to be prescribed a β-blocker. There was an 8.3{\%} increase in patient compliance with β-blocker therapy from preintervention to postintervention. In the first 2 years of the intervention, the estimated cost savings to the Pennsylvania Medicaid program ranged from $71 970 to $76 678, respectively. An estimated 3 deaths were avoided. Conclusions: The intervention resulted in increased appropriate prescribing and compliance with β-blockers among post-AMI patients. There also were estimated cost savings to Pennsylvania Medicaid as a result of reduced hospitalization, and fewer deaths.",
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