Biomedical subjects

William C Wadland

Publications and source records attributed to William C Wadland.

4 recordsLinked to original sources

PubMed2005

Increasing generic prescribing: a resident educational intervention.

BACKGROUND AND OBJECTIVES: Future physicians are urged to balance effectiveness and cost in their prescribing of medications. This study determined whether educational sessions for residents together with a "Resident Report Card" changed residents' prescribing of generic medications in both commercial and Medicaid patient panels, compared with regional performance of physicians in practice in the community. METHODS: Twenty-four family medicine residents providing care for 1,038 (600 Medicaid and 438 commercial) members (or 31,140 total member months) received biannual profiles of their prescribing patterns and participated in four training sessions related to prescription profiling within a regional health plan. We monitored prescribing during two time periods and compared rates of generic prescribing to a baseline rate. RESULTS: Resident generic prescribing increased significantly for commercial members, from a base period (July 1, 2000-June 30, 2001) rate of 38.4% to a period 1 (July 1, 2001-June 30, 2002) rate of 38.0% and a period 2 (July 1, 2002-December 31, 2002) rate of 47.9%. It also increased for Medicaid members, from a base period rate of 47.8% to a period 1 rate of 49.1% and a period 2 rate of 52.6%. There was no similar change in regional prescribing performance during the same periods for physicians in practice in the community. CONCLUSIONS: Feedback systems and training based on actual health plan data can be developed for residency training on prescribing performance, resulting in improved cost-efficient prescribing patterns.

Drug Costs↗

PubMed2005

Recruiting health plan members receiving pharmacotherapy into smoking cessation counseling.

BACKGROUND: Smokers receiving pharmacotherapy and individualized smoking cessation counseling through telephone quitlines have been found to have higher quit rates than smokers receiving pharmacotherapy alone. Health plans are often positioned to encourage their members to use quitline services in addition to pharmacotherapy. OBJECTIVE: To determine if healthcare members who were receiving pharmacotherapy increased their participation in smoking quitline services after receiving proactive telephone calls or postcards. STUDY DESIGN: Randomized controlled trial. METHODS: Health plan members filing pharmacotherapy claims were identified weekly from health plan pharmacy claims data and randomized to 1 of the following 3 conditions: control, recruitment postcard, or recruitment telephone call by a nurse quitline counselor. Enrollment of study members into the quitline program was tracked for 1 month after randomization. RESULTS: During 5 months, 625 individuals were identified for participation in the study, with the following enrollment into the program: 0% to the control group, 1.3% to the postcard group, and 20.6% to the telephone call group (P < .001 for significance by group). Although costs for the telephone intervention were the most expensive, it was also the most cost effective, given its success in enrolling members into the program. CONCLUSIONS: Proactive telephone calling by smoking cessation nurse counselors to smokers receiving pharmacotherapy may be an effective method of enrolling smokers into a cessation quitline. Health plans should consider proactive telephone recruitment to improve use of quitline services.

Adult↗

PubMed2004

Medical comorbidity in addictive disorders.

Greater risks exist for medical comorbidities in persons with addictive disorders. Clinicians should screen for early comorbidities such as hepatitis C and HIV. During acute intoxications and overdoses, patients are at greater risk for major respiratory and cardiac events. Long-term management of persons with addictions and medical disorders requires integrative care programs involving comprehensive primary and psychiatric care.

Behavior, Addictive↗

PubMed2003

An examination of the process of relapse prevention therapy designed to aid smoking cessation.

The process of relapse prevention (RP) therapy is examined. Patients' responses were recorded primarily during telephonic, RP counseling designed to facilitate smoking cessation. A computer program that prompted counselor initiatives and provided a framework for the recording of patient responses guided counselor interaction with patients. A total of 437 patients took part in 1650 counseling sessions and reported 2882 urge/lapse situations. The 2531 situations, for which complete data were available, and 4879 coping responses were analyzed. The main findings are (1) the descriptions of urge/lapse situations provided by patients in treatment are similar to those derived by research that aimed to discover the determinants of relapse without specific treatment, (2) number of coping responses rather than number of situations is related to treatment outcome, and (3) the more coping responses discussed during treatment, the better the treatment outcome.

Adaptation, Psychological↗