Select SLIDE MASTER to Insert Briefing Title Here Vis isualiz ualizing ing pat patter erns ns of of as asthma hma medication medicat ion pr pres escr cribing ibing in in the he Milit ilitar ary Healt Health h System em us using ing Event entFlow Flow Tamra Meyer 1 , Megan Monroe 2 , Jeff Millstein 3 , Suji Xie 1 , Trinka Coster 1 1 Pharmacovigilance Center, Office of the Surgeon General, Department of the Army; 2 University of Maryland, Computer Science and HCIL; 3 Oracle Health Sciences Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 1 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here Research Question Are LABAs being misprescribed in the MHS? • Appropriate LABA Prescribing- Ordered Patterns – LABA only in conjunction with ICS = LABA/ICS – Step-up or step down therapy • SABA step-up to ICS step-up to LABA/ICS • LABA/ICS step down to ICS and/or SABA Acronym Alert ICS : Inhaled Corticosteroid LABA : Long-acting Beta Agonist MHS: Military Health System SABA : Short-acting Beta-Agonist Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 2 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here MHS Population Active duty, Family member guard, reserves of active duty, guard, reserves 9.5 million people have Family access to member of retired or Retired from benefits survivor active duty, guard, reserves Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 3 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here Data Source SOURCES REPOSITORY DATA MART ADMIN CLAIMS PHARMACOVIGILANCE DEFENSE APPLICATION SYSTEM (PVDAS) PHARMACY RECORDS MHS Data Repository ELIGIBILITY/ ENROLLMENT PII preprocessor EHR Acronym Alert EHR: Electronic Health Record PII: Personally Identifiable Information 110 HOSTS Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 4 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here Methods ID Group Start End Jan 2006-Jan 2011 1333 LABA_ICS 2006-01-13 2006-02-11 1333 LABA_ICS 2006-02-05 2006-03-05 1333 LABA_ICS 2006-03-03 2006-04-01 174,238 1333 SABA 2006-03-03 2006-04-01 Asthma 1333 ICS 2006-04-01 2006-04-30 patients with a 1333 ICS 2006-05-01 2006-05-30 new LABA Rx 1718 SABA 2008-06-23 2008-07-22 1718 ICS 2009-02-10 2009-03-10 1718 LABA_ICS 2009-02-24 2009-03-24 Categorize into groups and process file for EventFlow 100 patients Extract asthma medications surrounding LABA Rx Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 5 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here EventFlow: Ordered Patterns Are Combined Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 6 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here All Asthma Drugs Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 7 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here Align on First LABA-ICS Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 8 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here View LABA and ICS Only Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 9 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here LABA and ICS in Those Who Started With LABA Alone Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 10 23 May 2012
Select SLIDE MASTER to Insert Briefing Title Here EventFlow Summary • Simple data structure • Intuitive display • Alignment tool was very powerful-quickly and easily identified possible patterns of suboptimal LABA prescribing • Scaling up to larger samples is critical Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address 23 May 2012 Slide 11
Select SLIDE MASTER to Insert Briefing Title Here The Army’s Home for Health… Saving Lives and Fostering Healthy and Resilient People ~ Partnerships Built on Trust Oct-30-12 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address Slide 12 23 May 2012
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