Interpreting the findings of the IMPROVE study

B. L. Carter, Daniel C Malone, S. J. Billups, R. J. Valuck, D. J. Barnette, C. D. Sintek, S. Ellis, D. Covey, B. Mason, S. Jue, J. Carmichael, K. Guthrie, R. Dombrowski, D. R. Geraets, M. Amato

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Various findings of the Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers (IMPROVE) study are reviewed. Suggestions for future methodologies that will enhance this study are discussed. The IMPROVE study is one of the largest pharmaceutical care studies conducted. Although it was an intervention study that examined global outcomes following management by pharmacists, it was designed as an effectiveness study. Several new practice and research methods were developed, including a method to identify patients at high risk for drug-related problems utilizing pharmacy databases, a method to identify chronic diseases using pharmacy databases, a method to evaluate the structure and process for delivering pharmaceutical care in Veterans Affairs medical centers (VAMCs), and guidelines for providing care to patients in the IMPROVE study. Nine VAMCs participated in the study, and 1054 patients were randomized to either an intervention group (n = 523) or a control group (n = 531). Pharmacists documented a total of 1855 contacts with the intervention group patients and made 3048 therapy-specific interventions over the 12-month study period. There was no meaningful difference in patient satisfaction or quality of life in the two groups. Selected disease-specific indicators found an improved rate of measurement of hemoglobin A1c tests and better control of total and low-density-lipoprotein (LDL) cholesterol levels in the intervention group compared with the control group. Total health care costs increased in both groups over the 12-month period. The mean increase in costs in the intervention group was $1020, which was lower than the control group's value of $1313. The lessons learned from the IMPROVE study suggest to future investigators how to study and measure the effects of clinical pharmacy services on patient outcome.

Original languageEnglish (US)
Pages (from-to)1330-1337
Number of pages8
JournalAmerican Journal of Health-System Pharmacy
Volume58
Issue number14
StatePublished - Jul 15 2001
Externally publishedYes

Fingerprint

Pharmaceutical Services
Veterans
Pharmacists
Control Groups
Hospital Pharmacy Services
Databases
Managed Care Programs
Patient Satisfaction
Health Care Costs
LDL Cholesterol
Patient Care
Hemoglobins
Chronic Disease
Quality of Life
Research Personnel
Guidelines
Costs and Cost Analysis
Research
Pharmaceutical Preparations
Therapeutics

Keywords

  • Administration
  • Clinical pharmacists
  • Clinical pharmacy
  • Clinical studies
  • Costs
  • Databases
  • Department of Veterans Affairs
  • Economics
  • Interventions
  • Managed care systems
  • Methodology
  • Outcomes
  • Patient care
  • Pharmaceutical care
  • Pharmaceutical services
  • Pharmacy, institutional, hospital
  • Primary care
  • Quality of life
  • Toxicity

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Leadership and Management

Cite this

Carter, B. L., Malone, D. C., Billups, S. J., Valuck, R. J., Barnette, D. J., Sintek, C. D., ... Amato, M. (2001). Interpreting the findings of the IMPROVE study. American Journal of Health-System Pharmacy, 58(14), 1330-1337.

Interpreting the findings of the IMPROVE study. / Carter, B. L.; Malone, Daniel C; Billups, S. J.; Valuck, R. J.; Barnette, D. J.; Sintek, C. D.; Ellis, S.; Covey, D.; Mason, B.; Jue, S.; Carmichael, J.; Guthrie, K.; Dombrowski, R.; Geraets, D. R.; Amato, M.

In: American Journal of Health-System Pharmacy, Vol. 58, No. 14, 15.07.2001, p. 1330-1337.

Research output: Contribution to journalArticle

Carter, BL, Malone, DC, Billups, SJ, Valuck, RJ, Barnette, DJ, Sintek, CD, Ellis, S, Covey, D, Mason, B, Jue, S, Carmichael, J, Guthrie, K, Dombrowski, R, Geraets, DR & Amato, M 2001, 'Interpreting the findings of the IMPROVE study', American Journal of Health-System Pharmacy, vol. 58, no. 14, pp. 1330-1337.
Carter BL, Malone DC, Billups SJ, Valuck RJ, Barnette DJ, Sintek CD et al. Interpreting the findings of the IMPROVE study. American Journal of Health-System Pharmacy. 2001 Jul 15;58(14):1330-1337.
Carter, B. L. ; Malone, Daniel C ; Billups, S. J. ; Valuck, R. J. ; Barnette, D. J. ; Sintek, C. D. ; Ellis, S. ; Covey, D. ; Mason, B. ; Jue, S. ; Carmichael, J. ; Guthrie, K. ; Dombrowski, R. ; Geraets, D. R. ; Amato, M. / Interpreting the findings of the IMPROVE study. In: American Journal of Health-System Pharmacy. 2001 ; Vol. 58, No. 14. pp. 1330-1337.
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