Iowa medicare beneficiaries' satisfaction and experiences with a prescription drug discount card and preferred drug list.

OBJECTIVE: To evaluate the expectations, experiences, and satisfaction with the Iowa Priority Prescription Savings (IPPS) program. DESIGN: Longitudinal descriptive study. SETTING: Iowa. PARTICIPANTS: Randomly selected Iowa Medicare beneficiaries who self-enrolled in the IPPS prescription discount card program. INTERVENTIONS: Three self-administered surveys mailed in November 2002, June 2003, and September 2004, during the first, second, and third years of IPPS operation. MAIN OUTCOME MEASURES: Expectations of drug discounts, amount of discounts received, awareness of the IPPS preferred drug list (PDL), and satisfaction with the program. RESULTS: Usable response rates for the three surveys were 43.5%, 31.0%, and 38.4%. About one fourth of members initially expected discounts of more than 20% on their prescription medications. After IPPS was implemented, many members were unaware of the discounts they were receiving, but the percentage of members reporting discounts of more than $20 per month increased from 7.4% in year 1 to 16.4% in year 3. More than one half of the members were unaware of which drugs were on the PDL in years 1 and 2, but this improved to 21% unawareness in year 3. Satisfaction with the program was low but improved over time. Members who received discounts, did not expect large discounts, or received a medication review were more satisfied with the program. CONCLUSION: Some IPPS members had unrealistic expectations about the amount of discounts they would receive, and expectations of large discounts decreased satisfaction. Satisfaction and amount of discounts improved over time, and beneficiaries whose medications were reviewed, usually by a pharmacist, were more satisfied with the program. PDL awareness was a problem despite substantial educational efforts by IPPS, a finding that has implications for the recently implemented Medicare Part D drug benefit.

Population-based medication reviews: a descriptive analysis of the medication issues identified in a medicare not-for-profit prescription discount program.

BACKGROUND: Medication reviews may be an important strategy to improve medication use, especially for individuals receiving many drugs. OBJECTIVE: To describe the types of medication issues and recommendations identified in the Iowa Priority Brown Bag Medication Reviews, compare individuals with medication issues with those without medication issues, and describe Iowa Priority enrollees' experiences with and satisfaction of the review. METHODS: A retrospective review of enrollment forms and medication review records and a survey of Iowa Priority members were conducted in 2002. Subjects were Medicare-eligible individuals who joined the Iowa Priority Prescription Savings Program. Frequency distributions and descriptive statistics were calculated. Analysis using t-test and chi(2) test determined differences between individuals with and without issues regarding use of drug therapy. RESULTS: Almost 13% of Iowa Priority enrollees received a review. There were 1167 individuals with 2123 medication issues identified. Nonprescription medications accounted for one-third of drug interactions and >40% of duplications. People with issues had poorer health, more chronic conditions, and took more drugs than people without medication issues. One-third of survey respondents discussed the review with their physicians, and 17.7% reported medication changes. Satisfaction with the review was good; however, only 24% were likely to have received an annual review. CONCLUSIONS: Iowa Priority Brown Bag Medication Reviews showed that individuals with fair/poor health, higher numbers of medications, and more chronic conditions were likely to have medication issues. Reviews generated discussions between physicians and patients, produced some medication changes, and helped individuals save money.

The rapid implementation of a statewide emergency health information system during the 1993 Iowa flood

In the face of disastrous flooding, the Iowa department of public health established the statewide emergency computer communications network to establish rapid electronic reporting of disaster related health data, provide e-mail communications among all country health departments, monitor the long - range public health effects of the disaster, and institute a general purpose public health information system in Iowa, Based on software (CDC wonder/PC) Provided by the centers for Disease control and prevention and using standard personal computers and modems, this system has resulted in a 10 - to 20 fold increase in surveillance efficiency at the health department, not including time saved by country network participants. It provides acritical disaster assessment capability to the health department but also facilitates the general practice of public health (AU)