Pharmacy & Therapeutics - February 2009 - (Page 83)

Asthma Utilization Rx Analyzer (AURA) Tool Table 3 Example of Short-Acting Beta Agonist (SABA) Utilization Output* Plan† Total No. (%) Persistent No. (%) Non-Persistent No. (%) 13,449 (100%) 4,459 (33%) 1,055 (8%) 376 (3%) 226 (2%) 151 (1%) 81 (1%) 326 (2%) 3,457 (100%) Total No. (%) Reference‡ Persistent No. (%) Non-Persistent No. (%) 13,449 (100%) 4,459 (33%) 1,055 (8%) 376 (3%) 226 (2%) 151 (1%) 81 (1%) 326 (2%) 3,457 (100%) Adult Population Members with asthma Total members with 1 SABA claim Total members with 2 SABA claims Total members with 3 SABA claims Total members with 4 SABA claims Total members with 5 SABA claims Total members with 6 SABA claims Total members with 7 SABA claims 15,799 (100%) 2,350 (100%) 4,987 (32%) 1,300 (8%) 518 (3%) 320 (2%) 232 (1%) 133 (1%) 599 (4%) 528 (22%) 245 (10%) 142 (6%) 94 (4%) 81 (3%) 52 (2%) 273 (12%) 15,799 (100%) 2,350 (100%) 4,987 (32%) 1,300 (8%) 518 (3%) 320 (2%) 232 (1%) 133 (1%) 599 (4%) 528 (22%) 245 (10%) 142 (6%) 94 (4%) 81 (3%) 52 (2%) 273 (12%) SABA Pharmacy Claims (7 or more claims) 6,623 (100%) 3,076 (100%) Members with SABA Use 36 32 28 24 20 16 12 8 4 0 6,623 (100%) 3,076 (100%) Members with SABA Claims (%) 32 32 8 3 2 4 1 1 8 3 2 4 1 1 Total members with 1 SABA claim Total members with 2 SABA claims Total members with 3 SABA claims Total members with 4 SABA claims Total members with 5 SABA claims Total members with 6 SABA claims Total members with 7 or more SABA claims Plan Reference • The percentages above may not sum to 100% due to rounding of whole numbers. * Patients are defined as having persistent or non-persistent asthma based upon HEDIS 2007, Vol 2. National Committee for Quality Assurance.7 † Plan = Plan-specific data uploaded by the managed care organization. ‡ Reference = PharMetrics data preloaded with the AURA tool. be applied. A greater use of rescue medications indicates the need for better management of persistent asthma through the use of controller medications. Because prescription claims for controller medications are categorized by disease severity and by the number of claims per patient, health plans can easily examine any usage patterns that are greater or lower than the benchmark reference. For example, in Table 3, if a higher proportion of plan members are using SABAs relative to the PharMetrics reference, this may suggest that plan patients are not receiving appropriate therapy for long-term asthma control. Health plans can then evaluate whether controller medications are being underutilized, which may explain the frequent use of rescue agents. Poor asthma control may also be reflected by high demand for medical care, such as outpatient or emergency visits or hospitalization. As shown in Table 4, AURA presents asthmarelated emergency department utilization and medication use at various time intervals prior to the emergency department visit. If the proportion of plan members receiving appropriate controller treatment is low compared with the PharMetrics reference, several explanations may exist: 1. Patients are noncompliant with controller medications. 2. The controller medications used are not effective; perhaps the dose needs to be increased or the drug class needs to be changed. 3. Physicians might not be prescribing enough controller medications to help maximize asthma control in their patients. In each scenario, the information is readily supplied by AURA to assess outcomes at the patient and prescriber levels. Health plans may then run a more targeted analysis that evaluates specific criteria for improvement. Such interventions may consist of patient education programs to improve compliance, continuing education programs for practicing physicians, or removing potential barriers to care. HOW AURA IMPROVES QUALITY Overall, incorporating these measures allows users of the AURA tool to identify potential trends and outcomes for quality improvement opportunities and to decrease the cost of care. AURA advances the collection and reporting of asthma quality measures by: Vol. 34 No. 2 • February 2009 • P&T® 83

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

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