CER has become a national priority area for improving health care. CER provides evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care (see AHRQ description of CER). This information is essential for clinicians and patients to make informed decisions about the best medical treatment and for improving the delivery of health care across our nation. Through the American Recovery and Reinvestment Act of 2009, the federal government is investing $1.1 billion in this type of research (see HHS.gov information).
The health care delivery system was rated among the most important initial priority areas for CER by the Institute of Medicine (see IOM Report, 2009). Assisting healthcare systems to implement CER evidence is a critical step in improving the country’s health. It is also the focus of the UA CER Group, which is funded by a grant from the US Agency for Healthcare Research and Quality (AHRQ). Under the Effective Health Care Program, (AHRQ) is overseeing the development of CER reports and guides for clinicians and consumers. The UA CER Group helps clinicians in hospitals and managed care organizations keep current with ongoing CER reviews on pharmaceuticals.
The UA CER Group received a 3-year Innovative Adaptation and Dissemination of AHRQ Comparative Effectiveness Research Products, or iADAPT, grant to develop an innovative approach to disseminating CER information products to a targeted group (R18HS019220, D. Malone, Principal Investigator). The intent of the grant program is to increase the use, implementation, and impact of these AHRQ products, especially among difficult-to-reach populations.
Millions of Americans receive health care in hospitals and managed care organizations that have pharmacy and therapeutic (P&T) or formulary development committees to support the safe and effective prescribing of medications. Because hospitals are key providers of care for persons with limited or no health insurance, this research will reach underserved populations through the P&T committees that manage formulary and drug policies in organizations serving disadvantaged groups.
Clinicians serving on P&T or formulary development committees continuously evaluate the evidence to make informed decisions about how medicines are used, and ultimately, to ensure that patients receive the most appropriate therapy. Despite the extensive clinical training that pharmacists and physicians receive, CER methods are not commonly integrated into their respective training programs. In addition, little is known about the awareness and actual use of CER evidence in the P&T or formulary development process. This research project assesses the awareness and knowledge of AHRQ CER reports and promotes their dissemination and use by P&T and formulary development committees.
In the first year of the project (2010-2011), we collected information about how P&T Committees make formulary decisions. Later, in the first and second years, we used that information to guide the development of a 4-hour educational program tailored for formulary decision makers and their research support teams. We then conducted five 'live' workshops at national pharmacy and medical conferences. The workshops are currently being evaluated for their effectiveness. In the third and final year of the project (2012-2013), we will convert the most effective components of the 'live' workshops into web-based educational mini-modules that will be available on this website.