AHCPR GRANTS OF $14.5 MIL. FOR DRUG OUTCOME STUDIES

Executive Summary

AHCPR GRANTS OF $14.5 MIL. FOR DRUG OUTCOME STUDIES in 14 different research areas have been awarded, HHS' Agency for Health Care Policy and Research announced April 7. The agency said that drug therapy outcomes to be evaluated by the studies include "morbidity, mortality and health services use, and subjective measures such as quality of life and patient preferences." Results from the studies will be published in the medical literature, HCFA said. Several of the studies will compare outcomes in common diseases or medical conditions for which the standard first-line treatment is a subject of debate in the health care community. One study will "describe physician treatment and prescribing behavior in Colorado Medicaid patients with otitis media," including assessments of "outcomes, quality and expenditures," AHCPR said. The study, which has received a $640,000 grant, will run through June 1996, conducted by Stephen Berman, MD, University of Colorado Health Sciences Center. The merits of various otitis media treatments, including antibiotics and tubal insertion, have been the subject of a debate played out in several medical journal articles ("The Pink Sheet" April 27, 1992, T&G-4). AHCPR originally was scheduled to release treatment guidelines for otitis media in December 1992 ("The Pink Sheet" June 1, 1992, T&G- 14). A University of Washington School of Pharmacy study will investigate another treatment area that has been the subject of vigorous debate in recent years -- pediatric asthma. The study will evaluate "whether the provision of pharmaceutical care improves outcomes for pediatric and adolescent asthma patients," AHCPR said. The four-year study will be conducted by Andreas Stergachis, PhD, and is funded at $1.36 mil. The University of Minnesota School of Public Health's Judith Garrard, PhD, was granted $1.4 mil. over five years to study patient outcomes associated with use of antidepressant drugs in persons over the age of 65. Garrard will follow patients enrolled in a health maintenance organization and will measure "health services utilization, health status and quality of life." AHCPR is scheduled to release depression treatment guidelines for primary care physicians April 14. Three other studies will evaluate drug therapy issues primarily relating to the elderly: a study of "medication decisions and outcomes associated with rheumatoid arthritis and osteoarthritis patients' use of prescription and over-the-counter drugs"; a Vanderbilt University School of Medicine study entitled "Improving Outcomes in Elderly NSAID Users"; and an investigation by Duke University researchers of "cognitive impairment and medication usefulness." A $2.4 mil. evaluation of "the use, appropriateness and effectiveness of antimicrobial drugs in treating HIV-related illnesses, including AIDS" will be conducted by Richard Chaisson, MD, Johns Hopkins University. Albert Wu, MD, also of of Johns Hopkins, will conduct a study to test a "brief health status measure for acute Pneumocystis carinii pneumonia." Other studies will focus on issues such as tracking patient compliance using various automated methods, statistical methods of evaluating quality of life and computerized prospective drug utilization review.