Quality Update for September 23, 2004

67% of Chronically Ill Cut Back on Medications, AHRQ Study Finds AHRQ Releases 1st Volume of Review Series NQF, JCAHO Announce Patient Safety and Quality Awards NH Coalition to Hold Conference AMIA Names First CEO 67% of Chronically Ill Cut Back on Medications, AHRQ Study Finds One-Third Said Costs Never Discussed About two-thirds of chronically ill adults who cut back on their medications because of the cost don’t tell their doctors in advance, according to a study funded by the Agency for Healthcare Research and Quality. The study is published in the Sept. 13 issue of the Archives of Internal Medicine. John D. Piette, and his colleagues from the Center for Practice Management and Outcomes Research at the Veterans Adminstration Ann Arbor Healthcare System surveyed a panel of 4,055 adults 50 and older who reported taking prescription medication for diabetes, depression, heart problems or high cholesterol. Of these, 660 patients reported forgoing some medication in the prior year due to cost pressures and two-thirds of this group reported that they did not tell their clinicians in advance. About 35% of the 660 patients said that they never discussed medication costs in the prior year with their clinicians. The researchers found that most patients who failed to talk with their clinicians about medication costs said that none of their providers asked them about possible problems paying for their treatments. Patients also reported that they didn’t think their clinicians would be able to help them with this problem or that they were too embarrassed to discuss issues related to cost. Most patients who discussed the cost of prescription medication with their clinicians found their clinicians to be helpful and received a variety of forms of assistance such as free samples or a change in their regimen to a less-expensive or generic alternative. However, less than one-third of the patients who spoke to their clinicians about the cost of prescription drugs reported being given information about programs to assist patients with medication costs or sources of lower-cost refills. For more info, www.archinternmed.com. AHRQ Releases 1st Volume of Review Series The Agency for Healthcare Research and Quality has released the first volume in a series exploring human and organizational factors influencing quality improvement strategies and evaluating nine quality improvement strategies, tools, or processes aimed at reducing the quality gap. The series, AHRQ’s Evidence-based Practice Center Technical Reviews, “Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 1: Series Overview and Methodology” (Technical Review 9), is now available. The first volume outlines the challenges to translating research into clinical practice and the methodologies used in the report. Volumes 2 and 3 will focus on improving the treatment of patients suffering from diabetes and hypertension, respectively, which AHRQ expects will be available soon. For more info, www.ahrq.gov/clinic/qualgap1 or ahrqpubs@ahrq.gov. NQF, JCAHO Announce Patient Safety and Quality Awards The National Quality Forum and the Joint Commission on Accreditation of Healthcare Organizations have announced the 2004 recipients of the annual John M. Eisenberg Patient Safety and Quality Awards: Individual Achievement: Lucian Leape, MD, Harvard School of Public Health, Boston Research Achievement: Peter Pronovost, MD, PhD, Johns Hopkins University School of Medicine, Baltimore, MD; Innovation in Patient Safety and Quality at a National or Regional Level: Kaveh G. Shojania, MD, and Robert M. Wachter, MD, University of California, San Francisco, CA; and Maj. Danny Jaghab, Booke Army Medical Center, San Antonio, TX. Innovation in Patient Safety and Quality at a Local or Organization Level: University of Pittsburgh Medical Center, McKeesport, PA. NH Coalition to Hold Conference The National Citizens’ Coalition for Nursing Home Reform, NCCNHR, will hold a conference Oct. 17-20 in Arlington, VA designed for citizen advocates, ombudsmen, residents, family members, government officials, and others who are concerned about quality long-term care. Sunday includes a session on culture change and Monday’s agenda highlights the Alzheimer’s Association’s recommendations for quality practices. The conference also covers staffing, reimbursement, work force issues, facility transformation and resident care in five plenary and 25 breakout sessions. NCCNHR offers a number of resident-focused resources that relate to real life issues often experienced by residents: NCCNHR Publications. The publications list includes the book, “Nursing Homes, Getting Good Care There,” as well as booklets on physical and chemical restraints that contain basic information related to restraints, a new video on family councils, and a special booklet designed for families on staffing issues – “Nursing Home Staffing: A Guide for Residents, Families, Friends and Caregivers”. Study on Resident Perspectives On Quality Care. In 1985, NCCNHR conducted focus groups of residents across the United States to determine what is most important to the resident experience, which is available in the Library section at www.nursinghomeaction.org. Video on Resident Involvement in Total Quality Management. Terra Nova films sells a video about the work of the Citizen Advocacy Group in New York – Long Term Care Community Coalition – involving residents in the TQM process. The Ombudsman Network. Visit www.ltcombudsman.org to find current information about ombudsmen in your state and to learn more about the ombudsman program. NCCNHR houses the National Long-Term Care Ombudsman Resource Center which is directed by Lori Smetanka, Esq. AMIA Names First CEO The Board of the American Medical Informatics Association (AMIA) announced that Don E. Detmer, MD, MA has been named president and CEO of the association. Detmer, MD, MA, will retain his position of Professor Emeritus and Professor of Medical Education in the Department of Health Evaluation Sciences at the University of Virginia. He is also Senior Associate of the Judge Institute of Management, University of Cambridge, a trustee of the Nuffield Trust of London, and a fellow of Clare Hall at Cambridge. He is a member of the Institute of Medicine, a lifetime Associate of the National Academies, and a fellow of AAAS, Academy Health, and the American Colleges of Medical Informatics, Surgeons, and Sports Medicine. He is immediate past chairman of the Board on Health Care Services of the IOM as well as the National Committee on Vital and Health Statistics. He has also chaired the Board of Regents of the National Library of Medicine. “We are pleased that such a distinguished fellow of our college of informatics and a world renowned physician will be leading AMIA in these exciting times,” said AMIA Chairman Charles Safran, MD. For more info, www.amia.org. Back to top

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