title: Provision of drug information to patients by pharmacists: the impact of the Omnibus Budget Reconciliation Act of 1990 a decade later.
abstract: Drug-related illness in the United States factors substantially in health care costs, although often these illnesses and their attendant costs are preventable. One strategy for minimizing adverse drug reactions is to provide drug information to consumers in the form of prescription counseling at pharmacies. The Omnibus Budget Reconciliation Act of 1990 (OBRA 1990) contained provisions for mandating such counseling to Medicaid patients. OBRA 1990 was implemented in 1993, but most states acted quickly to extend counseling services to all patients receiving prescription drugs. We looked at the extent and quality of prescription counseling available in community pharmacies 1 decade after OBRA 1990 was written. We evaluated the counseling services afforded at large chain pharmacies, independent community pharmacies, and on-line pharmacies for a hydrochlorothiazide prescription. We found that most (69%) pharmacies offered to provide prescription counseling service, and that average counseling index scores, a measure of the quality or extent of information provided as determined by a Rasch analysis, were generally satisfactory. Our observations based on a single prescription for hydrochlorothiazide, along with other studies, suggest that there is a positive upward trend in the number of pharmacies providing prescription drug information, and that the extent of information provided suggests that the objectives of OBRA 1990 and related legislation to reduce ADRs are being fundamentally satisfied.
authors.affiliation: Department of Pharmacology, College of Pharmacy, The University of Toledo, 2801 W. Bancroft Street, Toledo, OH 43606, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Schatz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Belloto
authors.forename: Donald B
authors.initials: DB
authors.lastname: White
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bachmann
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002017:Budgets / Q000331:legislation & jurisprudence; D003376:Counseling; D005069:Evaluation Studies as Topic; D006301:Health Services Needs and Demand; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D008484:Medicaid / Q000331:legislation & jurisprudence*; D010353:Patient Education as Topic; D010593:Pharmaceutical Services / Q000191:economics / Q000331:legislation & jurisprudence* / Q000592:standards*; D010594:Pharmacies / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide