Patient Safety, 2012

Georgia QIO Uses AHRQ DVD and Brochure to Educate Medicare Patients About Safe Use of Blood Thinners

January 2012

Alliant/GMCF, Georgia's Quality Improvement Organization (QIO), used AHRQ's DVD and brochure "Staying Active and Healthy With Blood Thinners" as part of an educational program that helps Medicare patients safely manage their anticoagulation therapy and overall health.

The Georgia QIO launched an initiative to decrease drug interactions for patients who take warfarin. The group distributed AHRQ's blood thinner DVD and brochure to 1,400 Medicare Part D beneficiaries who filled prescriptions for warfarin in the first quarter of 2009. The work was funded under contract with the Centers for Medicare and Medicaid Services in the 9th Scope of Work.

"In our efforts to decrease drug-to-drug interactions among seniors, we found that our largest challenge was in the combination of other drugs prescribed to patients who are on warfarin. We felt that patient education should be a major focus for our quality initiative. The DVD and brochure mailing was an essential part of our effort," explains Adrienne Mims, MD, MPH, Medical Director, Medicare Quality Improvement at Alliant/GMCF.

The multipronged education campaign consisted of a number of materials, as follows:

• Patient outreach mailings:
  • A letter explaining the importance of bringing medications to every visit.
  • A followup mailing sent 2 months later that contained AHRQ's blood thinner DVD and brochure.
• Patient resources:
  • Bags for bringing medications to appointments.
  • Red bracelet that says "Warfarin alert."
  • Wallet card that says "I'm taking WARFARIN" on one side and a list of common drugs that interact negatively with the drug on the other.
• Physician outreach letters to doctors who had prescribed warfarin, asking them to review patients' medications at every visit.
• Provider resources:
  • Continuing medical education lecture "Drug Safety Initiative: Inappropriate Medications in Seniors."
  • Article "Anticoagulation Management in Primary Care" in the Georgia Academy of Family Physicians newsletter.

After the campaign ended, QIO staff measured differences in prescriptions written. Results revealed a desired drop in prescriptions that interact with warfarin. After the education initiative, there was a 14.5 percent reduction in warfarin prescriptions that were also filled with a medication that can interfere with its metabolism.

Mims notes, "The interventions had an impact on clinical practice by enabling physicians to choose safer medications for seniors. In addition, empowering patients and caregivers with information that had a significant health impact allowed them to be more active participants in care decisions."

The DVD helps patients better understand anticoagulation therapy and how to manage it effectively. It is designed to complement education that patients receive in their doctor's office, clinic, pharmacy, or hospital. The video can be downloaded at http://www.ahrq.gov/consumer/btpills.htm#videos.

Impact Case Study Identifier: CQuIPS-12-03
AHRQ Products: Staying Active and Healthy With Blood Thinners
Topic(s): Patient Education, Chronic Disease Management, Prescription Medication
Scope: Georgia

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