Musculoskeletal disorders (MSDs) affect over 40 million Americans and are the leading cause of activity limitations. Health care costs for arthritis and osteoporosis alone exceed 75 billion dollars per year. In the past 5 years, there has been a dramatic rise in the number of new FDA approved therapies for MSD treatment. Society faces difficult questions of how best to use new versus existing therapies in an equitable, efficient and cost-effective fashion. The long-term objective of this proposal is to establish a self-sustaining Center for Education and Research on Therapeutics (CERT) of MSDs. The CERT will combine substantial UAB clinical and health services research expertise with private sector collaborations to evaluate the effectiveness and safety of new MSD therapeutics and to guide changes in the practice community.
The specific aims of the CERT are to establish a core facility that will be utilized to: 1) In collaboration with AHCPR/FDA, conduct outcomes and effectiveness research on high profile MSD projects that are generated internally, from our partners in managed care organizations and in the pharmaceutical industry, and from other CERTs. Our CERT will use both private and public national data sources and will build on the diverse resources of UAB Schools, Centers, and Programs; 2) Identify variations in the use of MSD therapeutics and explore the causes of these variations in practices by examining their association with scientific evidence, provider, care system, patient and community characteristics; 3) Using previously well-tested methodology, effectively disseminate new knowledge about MSD therapeutics to practitioners, insurers, policy makers, and the general public. Emphasis will be placed on altering provider behavior via education on evidence-based guidelines, quality of care indicators, and peer performance. A study of glucocorticoid-induced osteoporosis, an endemic problem that is currently inadequately treated, highlights selected CERT capabilities. Other demonstration studies addressing arthritis and osteoporosis problems of high current interest are also proposed. The UAB CERT, a cooperative agreement with AHCPR, will encompass broad and rapidly emerging therapeutic areas in all MSDs that affect predominantly older and other high-risk populations. We demonstrate that future viability of the CERT will follow form our broad-base of public and private sector support. Our findings and interventions will address health care policy concerns of significant National importance.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration--Cooperative Agreements (U18)
Project #
3U18HS010389-01S1
Application #
6421682
Study Section
Special Emphasis Panel (ZHS1 (01))
Program Officer
Bosco, Lynn
Project Start
2000-07-01
Project End
2003-06-30
Budget Start
2000-07-01
Budget End
2001-06-30
Support Year
1
Fiscal Year
2001
Total Cost
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004514360
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Miller, Michael J; Allison, Jeroan J; Cobaugh, Daniel J et al. (2014) A group-randomized trial of shared decision making for non-steroidal anti-inflammatory drug risk awareness: primary results and lessons learned. J Eval Clin Pract 20:638-48
Kilgore, M L; Outman, R; Locher, J L et al. (2013) Multimodal intervention to improve osteoporosis care in home health settings: results from a cluster randomized trial. Osteoporos Int 24:2555-60
Schmitt, Michael R; Miller, Michael J; Harrison, Donald L et al. (2011) Communicating non-steroidal anti-inflammatory drug risks: verbal counseling, written medicine information, and patients' risk awareness. Patient Educ Couns 83:391-7
Pisu, Maria; Crenshaw, Katie; Funkhouser, Ellen et al. (2010) Medication assistance programs: do all in need benefit equally? Ethn Dis 20:339-45
Patkar, Nivedita M; Curtis, Jeffrey R; Teng, Gim Gee et al. (2009) Administrative codes combined with medical records based criteria accurately identified bacterial infections among rheumatoid arthritis patients. J Clin Epidemiol 62:321-7, 327.e1-7
LaCivita, Cynthia; Funkhouser, Ellen; Miller, Michael J et al. (2009) Patient-reported communications with pharmacy staff at community pharmacies: the Alabama NSAID Patient Safety Study, 2005-2007. J Am Pharm Assoc (2003) 49:e110-7
Angner, Erik; Ray, Midge N; Saag, Kenneth G et al. (2009) Health and happiness among older adults: a community-based study. J Health Psychol 14:503-12
Mudano, A S; Bian, J; Cope, J U et al. (2009) Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int 20:819-26
Cobaugh, Daniel J; Angner, Erik; Kiefe, Catarina I et al. (2008) Effect of racial differences on ability to afford prescription medications. Am J Health Syst Pharm 65:2137-43
Kovac, Stacey H; Saag, Kenneth G; Curtis, Jeffrey R et al. (2008) Association of health-related quality of life with dual use of prescription and over-the-counter nonsteroidal antiinflammatory drugs. Arthritis Rheum 59:227-33

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