Pharmaceutical Safety Tracking (PhaST): Managing Medications for Patient Safety (Ohio)

Project Activities

Summary: 

This project evaluated the Pharmaceutical Safety Tracking (PhaST) system, which monitors medication safety in children and adolescents who are taking antidepressants. The use of these medications in this group has grown as significant benefits have been recognized. With known risks of suicidality and manic activation, close monitoring of these individuals is critical. Because of the lack of availability of an automated monitoring system such as PhaST, clinicians are forced to rely on frequent face-to-face office visits to accomplish this. Many families, however, are unable to visit their clinicians at the desired frequency due to financial, organizational, and geographic barriers. These children and adolescents may not receive adequate medication safety monitoring, since those with the least access to services have the least supervision.

A main feature of PhaST is an interactive voice response (IVR) telephony component that automates the monitoring of adherence, side effects, and symptoms. If a problem with a medication is reported by a patient on an IVR call, the system automatically alerts a nurse trained to triage issues who will counsel the patient or their family, contact the patient’s physician, or activate emergency services as warranted. The main objectives of this project were to:

  • Determine whether PhaST is superior to usual care on measures of system process.
  • Determine whether PhaST is superior to usual care on measures of patient and provider outcomes.

The project evaluated PhaST via a randomized clinical trial that compared the use of the automated system to usual treatment. Participants included families with children aged 6-17 years who were newly prescribed an antidepressant. On average, those families randomized to the PhaST arm received approximately seven IVR screening calls over a period of 3 months. During the calls, respondents were asked eight screening questions that focused on potential side effects of their medication, medication adherence, worsening of clinical state, suicidality, and unusual changes in behavior.

The PhaST system was able to reach its targeted rate of followup supervision. Significantly higher rates of mental health problems were reported by study families to PhaST. The information collected increased the amount of information available to clinicians on the mental health condition of their patients without burdening them with additional tasks.

Grant Number: 
R18 HS 017258
Category: 
Ambulatory Safety and Quality Program: Improving Quality through Clinician Use of Health IT (R18)
AHRQ Funded Amount: 
$1,156,142
Principal Investigator: 
Gardner, William
Organization: 
Children's Research Institute
City: 
Columbus
Location: 
Ohio
Project Dates: 
September 4, 2007 to May 31, 2011
Project Status: 
Closed

Project Categories

Type of Health Information Technology: 
Interactive Voice Response (IVR)/Telephony
Community: 
Non-rural
Care Setting: 
Ambulatory
Home
Mental Health Provider
Specialty Practice
Aspect of Care: 
Medication Management
Specialty Care
Target Population: 
Medicaid
Mental Health/Depression
Pediatric
Last Modified: May 2013

News and Publications

Gardner W. Pharmaceutical Safety Tracking (PhaST): Managing Medications for Patient Safety - Final Report. (Prepared by Children's Research Institute under Grant No. R18 HS017258). Rockville, MD: Agency for Healthcare Research and Quality, 2012. (PDF, 333.33 KB)