title: Frequency and characteristics of cognitive services provided in response to a financial incentive.
abstract: OBJECTIVE
  To determine the effects of a financial incentive on the number and types of cognitive services (CS) provided by community pharmacies to Medicaid recipients in the State of Washington.
  
  
  METHODS
  Prospective randomized trial. CS were reported using a problem-intervention-result coding system over a 20-month period.
  
  
  METHODS
  Pharmacists practicing in 110 study (financial incentive) and 90 control community pharmacies.
  
  
  RESULTS
  Study pharmacists documented an average of 1.59 CS interventions per 100 prescriptions over a 20-month period, significantly more than controls, who documented an average of 0.67 interventions (P < .05) per 100 prescriptions. One-half (48.4%) of all CS were for patient-related problems, 32.6% were for drug-related problems, 17.6% were for prescription-related problems, and 1.4% were for other problems that did not involve drug therapy. A change in drug therapy occurred as a result of 28% of all CS documented in this demonstration. Changes were rarely (2.4%) due to generic or therapeutic substitution and almost always (90%) followed communication with the prescriber. The average self-reported time to perform CS was 7.5 minutes; 75% of interventions were < or = 6 minutes. Considerable differences existed between study and control groups in the types of problems identified, intervention activities performed, and results of interventions.
  
  
  CONCLUSIONS
  A financial incentive was associated with significantly more, and different types of, CS performed by pharmacists.
authors.affiliation: Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, University of North Carolina at Chapel Hill, NC 27599-7360, USA. dale_christensen@unc.edu
authors.forename: D B
authors.initials: DB
authors.lastname: Christensen
authors.forename: N
authors.initials: N
authors.lastname: Neil
authors.forename: W E
authors.initials: WE
authors.lastname: Fassett
authors.forename: D H
authors.initials: DH
authors.lastname: Smith
authors.forename: G
authors.initials: G
authors.lastname: Holmes
authors.forename: A
authors.initials: A
authors.lastname: Stergachis
mesh_terms: D003072:Cognition Disorders / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D011446:Prospective Studies