Pharmacy & Therapeutics - February 2009 - (Page 80)

Better Asthma Management with Advanced Technology Creation of an Asthma Utilization Rx Analyzer (AURA) Tool James H. Jackson, PharmD, MPH; Benjamin Gutierrez, PhD; Orsolya E. Lunacsek, PhD, MBA; and Sulabha Ramachandran, PhD ABSTRACT With nearly 23 million people affected by asthma each year, optimizing care among patients with persistent disease is a constant challenge for health care providers. The Asthma Utilization Rx Analyzer (AURA) tool enables health plan managers to evaluate quality and resource utilization for its members with asthma by analyzing medical and pharmacy claims. Customizable quality measures allow users of the tool to generate results from specific plans in order to optimize asthma disease management. Although asthma care has improved considerably, more still needs to be done. In the U.S. in 2006 alone, asthma accounted for 14 million missed school days for children and 14.5 million sick days for adults, amounting to $4.6 billion in lost productivity.8 Clearly, new strategies and quality measurements are needed for continued improvements. RATIONALE FOR NEW TECHNOLOGY DEVELOPMENT Asthma management can be challenging and complex because of the diversity of the patient population, the lack of a clear correlation between disease severity and outcomes, the inherent variability and temporal aspects of the disease, and the problem of patient adherence to therapy.9 Although the premise of HEDIS is focused on improving the delivery of quality health care, health plans are constantly faced with the challenges of understanding and identifying quality improvement opportunities in the disease-management process. Measuring the use of controller and rescue medications and the consumption of other medical resources can provide critical information about the management of asthmatic patients in health plans. Because the approach to care should be managed at multiple levels, the ability to understand health plan utilization (e.g., use of controller medications, medical and pharmacy costs), patients’ use of resources (e.g., medication use, the need for acute care), and physician performance (e.g., prescribing habits, patient care outcome performance), is valuable to managed care organizations (MCOs). Collectively, this information can be used to identify ways of improving treatment. The ability to compare plan-specific utilization criteria with national or regional performance benchmarks may provide a comprehensive approach to improving asthma care. Many MCOs and physician organizations do not have the internal resources available to analyze these performance measures. Consequently, a tool for asthma management was developed to support quality improvement initiatives and to enhance appropriate asthma medication usage among adults and children. INTRODUCTION As one of the most prevalent chronic diseases in the U.S., asthma affects approximately 23 million people each year; the prevalence rate is 7.3% in adults and 9.4% in children.1,2 Over the past two decades, the prevalence of asthma has increased, accounting for approximately 13 million physician office visits, 1.8 million hospital emergency visits, and close to 500,000 hospitalizations annually in the U.S.3–5 Asthma causes almost 12.8 million missed school days in children and 14.5 million lost work days in adults each year.3,5 The annual economic burden associated with asthma is approximately $19.7 billion in health care costs, with prescription drugs as the major cost driver of direct medical expenditures.3,4 Because of the significant health, social, and economic costs of asthma, the need to improve therapeutic outcomes through better disease management has become the focus of paramount importance in recent years. In an ongoing effort to improve the care of patients with asthma, the National Asthma Education and Prevention Program of the National Heart, Lung, and Blood Institute (NHLBI) recently updated evidence-based treatment guidelines to assist health care providers in delivering optimal disease management.6 In addition, technical specifications of the Healthcare Effectiveness Data and Information Set (HEDIS) included a measure for the appropriate use of asthma medications in health plans in accordance with the guidelines. This HEDIS measure is used to evaluate the percentage of patients (5 to 56 years of age) with persistent asthma who received appropriate drug therapy for long-term asthma control.7 The proportion of identified health plan members meeting this metric improved from 57.7% in 1998 to 89.9% in 2005 and to 91.6% in 2006.8 Dr. Jackson is Senior Director and Dr. Lunacsek is Assistant Director, both at Xcenda in Palm Harbor, Florida. Dr. Gutierrez is Director of Health Economics and Outcomes Research, and Dr. Ramachandran is Associate Director of Health Economics and Outcomes Research, both at AstraZeneca LP in Wilmington, Delaware. AURA AURA is a software tool that can be used by health plans to analyze their health care claims data in order to manage medication use and quality of care for their members with asthma.10 AURA is designed to examine patterns and costs of asthma medication and health care resource use within a health plan’s population at a defined period (i.e., a cross-sectional analysis). Evaluations can then be repeated at subsequent time periods to assess long-term trends. Disclosure: The authors have no financial or commercial relationships to report in regard to this article. Accepted for publication December 22, 2008 80 P&T® • February 2009 • Vol. 34 No. 2

Table of Contents Feed for the Digital Edition of Pharmacy & Therapeutics - February 2009

Pharmacy & Therapeutics - February 2009 Contents Editorial Medication Errors Prescription: Washington New Drugs/Drug News/New Medical Devices Drug Forecast Pushing an Expanded Role for Pharmacists Better Asthma Management with Advanced Technology Pharmaceutical Approval Update 58th Annual Meeting, American Society of Human Genetics, 2008 American Society of Hematology, 50th Annual Meeting and Exposition 2008 San Antonio Breast Cancer Symposium Stahl’s Essential Psychopharmacology, 3rd Edition Author Guidelines

Pharmacy & Therapeutics - February 2009

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.