Comparative Effectiveness, 2008

Omnicare, Inc.

July 2008

Omnicare, Inc., a leading provider of pharmaceutical care for the elderly, uses AHRQ's Effective Health Care (EHC) Program guides as tools for its consultant pharmacists and facilities, which are primarily nursing homes. Omnicare serves approximately 1.4 million residents in more than 15,000 long-term care facilities in 47 states, Washington, D.C., and Canada.

According to Gary Erwin, Senior Vice President, Professional Services, his organization has used three EHC guides. However, he says, the most valuable has been Off-Label Use of Atypical Antipsychotic Drugs. "This guide seems almost as though it was targeted directly to our needs."

Although Omnicare staff had searched for other "neutral third-party" sources of comparative information on this topic, Erwin says, they had been unsuccessful before finding AHRQ's guide. He notes, "The guide was very well done. We found it to be an excellent summary by an independent third party that met our specific needs and served a valuable purpose."

Because Omnicare considered the guide to be so useful, the company distributed it electronically to its approximately 700 consultant pharmacists, who were asked to share it with all the facilities with which they worked.

Most of the facilities Omnicare serves care for people with dementia. Erwin explains that the guide assists with efforts toward gradual dose reductions. "It helps keep people focused on the appropriate use of drugs." For many residents with behavioral disturbances associated with dementia, the use of antipsychotic drugs is always "a balancing act," Erwin notes, "to use the lowest dose possible, if a drug is necessary, while keeping the person and those around them safe."

In addition to the antipsychotic drug guide, Omnicare also uses the EHC guides on Medications for Adults with Rheumatoid Arthritis and Non-Opioid Analgesics for Osteoarthritis. The guides are produced by AHRQ's Evidence-based Practice Centers and serve as hallmarks of the congressionally mandated EHC Program. They draw on published studies to produce evidence-based comparisons of medications, devices, and other interventions.

Omnicare, Inc., is a Fortune 500 company based in Covington, Kentucky. As part of its services to nursing facilities, the company performs federally mandated medication regimen reviews of each resident's medical history. Omnicare works with caregivers to do the following:

1. Assure documentation of all diagnoses/conditions experienced by a resident.
2. Ensure the establishment of treatment goals as part of a multidisciplinary effort, as well as the documentation of monitoring for, progress towards, or maintenance of, those goals.
3. Discover instances of medication overuse, misuse, and underuse.
4. Identify instances where more cost-effective therapy may be available.
5. Evaluate and document the potential contribution of drug therapy to unanticipated changes in the resident's condition.

For more information, visit the company's Web site at www.omnicare.com.

Impact Case Study Identifier: COE 08-07
AHRQ-Sponsored Activity: Effective Health Care
Topic(s): Prescription Drugs, Long-Term Care
Scope: National & Canada

Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics, January 2007. Comparative Effectiveness Review No. 6. Agency for Healthcare Research and Quality, Rockville, MD. http://effectivehealthcare.ahrq.gov/repFiles/Atypical_Antipsychotics_Final_Report.pdf [PDF File, 550 KB; Plugin Software Help].

Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in Adults, November 2007. Comparative Effectiveness Review No. 11. Agency for Healthcare Research and Quality. Rockville, MD. http://effectivehealthcare.ahrq.gov/repFiles/RheumArthritisFinal.pdf [PDF File, 788 KB; Plugin Software Help].

Comparative Effectiveness and Safety of Analgesics for Osteoarthritis, September 2006. Comparative Effectiveness Review No. 4. Agency for Healthcare Research and Quality. Rockville, MD. http://effectivehealthcare.ahrq.gov/repFiles/AnalgesicsFinal.pdf [PDF File, 580 KB; Plugin Software Help].

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