title: An evaluation of the relationship between the implementation of a newly designed prescription drug label at Target pharmacies and health outcomes.
abstract: BACKGROUND
  Medication errors represent a major public health concern, and inadequate prescription drug labels have been identified as a root cause of errors. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve health outcomes.
  
  
  OBJECTIVE
  To evaluate whether the new Target label influenced patient health services utilization.
  
  
  METHODS
  Derived from 2 large health plans. RESEARCH DESIGN AND MEASURES: Using administrative claims, we identified patients with 1 of 9 chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies. We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on outpatient, emergency department and inpatient health services use. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively.
  
  
  RESULTS
  Our sample included 23,745 Target pharmacy users and 162,369 matched non-Target pharmacy users. In the new-user analysis, we found no significant change in rates of both outpatient (event rate ratio: 0.53; 95% CI: 0.15-1.86) and inpatient and emergency department (Event rate ratio: 0.88; 95% CI: 0.62-1.24) health services utilization in Target users after implementation when compared with non-Target users. Similarly, in the prevalent user analysis, we found no change in the level or slope of outpatient or emergency/inpatient services in Target users after implementation of the new label when compared with non-Target users.
  
  
  CONCLUSIONS
  We found no statistically significant change in health services use attributable to the implementation of the new prescription drug label at Target pharmacies. These findings highlight the challenge of influencing health outcomes with interventions to improve health literacy.
authors: Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02120, USA. wshrank@partners.org
authors: William H
authors: WH
authors: Shrank
authors: Amanda
authors: A
authors: Patrick
authors: Patrick P
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authors: Gleason
authors: Claire
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authors: Canning
authors: Carol
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authors: Walters
authors: Alan H
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authors: Heaton
authors: Saira
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authors: Jan
authors: M Alan
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authors: Brookhart
authors: Sebastian
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authors: Schneeweiss
authors: Daniel H
authors: DH
authors: Solomon
authors: Michael S
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authors: Wolf
authors: Jerry
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authors: Avorn
authors: Niteesh K
authors: NK
authors: Choudhry
mesh_terms: D000328:Adult; D000368:Aged; D054869:Clinical Audit; D004348:Drug Labeling / Q000592:standards*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008875:Middle Aged; D008910:Minnesota; D017063:Outcome Assessment, Health Care; D010594:Pharmacies