Evaluation of a peptic ulcer disease information dissemination program in a managed care plan
Abstract
The purpose of this study was to evaluate the effectiveness of an information dissemination program including practice guidelines, treatment algorithms and peer comparison feedback in changing physicians' prescribing behaviors in the treatment of patients with peptic ulcer disease (PUD). A prospective intervention with a control group was conducted to determine the impact of an H. pylori eradication program on PUD. Physicians in Indiana who were members of the participating managed care network were stratified by prescribing volume and then grouped according to practice site. Each practice site was randomly assigned to the intervention group or the control group. Comparisons of changes in treatment patterns over the three-month study period were made to determine the impact of the program in changing physicians' behavior. The impact of the program on the utilization of eradication therapy, long-term antisecretory utilization and total cost of drug therapy per patient was assessed using pharmacy claims data. The impact of the program on patient health-related quality of life and patient satisfaction with care was assessed using telephone survey data. Even though they were not significant, there were increases in quality of life scores for the Mental Component Summary of the SF-12 and decreases in scores on the Dyspeptic Syndrome of the Gastrointestinal Symptom Rating Scale, which indicates a decrease in gastrointestinal symptoms. There was a significant increase in the utilization of eradication therapy for physicians in the intervention group compared to physicians in the control group during the post-intervention period. This increase in eradication utilization was not accompanied by a significant not accompanied by a significant increase in the total cost of drug therapy per patient for patients in the intervention group compared with patients in the control group. In conclusion, the main goal of the study, which was to increase the utilization of eradication therapy was achieved. An increase in prescribing eradication therapy of almost one percent was observed for physicians in the intervention group. To see some modification of physician behavior in only a three-month follow-up period is a very positive finding, which may indicate an even greater impact when the program is evaluated over a longer period of time.
Degree
Ph.D.
Advisors
Thomas, Purdue University.
Subject Area
Pharmaceuticals
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