About
My role is to help improve patient outcomes through evidence-based medicine. Staying…
Articles by Anthony
Activity
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As a child in Uganda, Hannet Tibagwa Ambord (MS ’00) developed a nasty case of chicken pox. “I needed to get daily injections for treatment,” she…
As a child in Uganda, Hannet Tibagwa Ambord (MS ’00) developed a nasty case of chicken pox. “I needed to get daily injections for treatment,” she…
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I had a great time connecting with old teammates and current students at my alma mater this past weekend for the Buena Vista University women's…
I had a great time connecting with old teammates and current students at my alma mater this past weekend for the Buena Vista University women's…
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A Lesson on Value and Cost In the corporate world, it’s not uncommon for companies to part ways with exceptionally talented employees due to salary…
A Lesson on Value and Cost In the corporate world, it’s not uncommon for companies to part ways with exceptionally talented employees due to salary…
Liked by Anthony Staresinic
Experience
Education
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Wayne State University
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Activities and Societies: Treasurer of Class of '96 Rho Chi
After completeing my bachelor's degree in pharmacy I pursued and achieved the doctor of pharmacy degree.
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Asthma/ Allergy Fellowship
Primary Care Residency at Madison VA Hospital
Publications
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Prompt Initiation of Triple Therapy Following Hospitalization for a Chronic Obstructive Pulmonary Disease Exacerbation in the United States: An Analysis of the PRIMUS Study
J Manag Care Spec Pharm, 2022 Dec;28(12):1366-1377
Triple therapy initiation within 30 days after a COPD hospitalization may improve patient outcomes in the following year. Benefits include lower risk of future exacerbations and avoiding thousands of dollars in health care costs. Triple therapy should be considered as an alternative to other treatments after a severe COPD exacerbation.
Other authorsSee publication -
A 4-Year Retrospective Claims Analysis of Oral Corticosteroid use and Health Conditions in Newly Diagnosed Medicare FFS Patients with COPD
International Journal of Chronic Obstructive Pulmonary Disease
This study highlights the potential risks of oral corticosteroids in COPD treatment, including prolonged use among complex Medicare patients, and reinforce the importance of preventive treatment strategies and therapy optimization early in the disease course.
Other authorsSee publication -
PRIMUS - Prompt Initiation of Maintenance Therapy in the US: A Real-World Analysis of Clinical and Economic Outcomes Among Patients Initiating Triple Therapy Following a COPD Exacerbation
International Journal of Chronic Obstructive Pulmonary Disease
Prompt initiation of triple therapy decreases risk of future exacerbations and is associated with lower all-cause and COPD-related healthcare utilization and costs, including lower prescription drug costs.
Other authorsSee publication -
Economic impact of pharmacist-reimbursed drug therapy modification
J Am Pharm Assoc.
Objectives: To determine (1) the frequency of the different types of drug therapy modification claims paid by a pharmacy benefits manager (PBM), (2) PBM cost savings and return on investment (ROI), and (3) patient savings from pharmacist-reimbursed drug therapy modifications.
Results: Claims were paid to pharmacists for drug therapy modifications to allow tablet splitting, drug therapy changes, and switching noncovered drugs. Tablet splitting provided the largest cost savings to the PBM,…Objectives: To determine (1) the frequency of the different types of drug therapy modification claims paid by a pharmacy benefits manager (PBM), (2) PBM cost savings and return on investment (ROI), and (3) patient savings from pharmacist-reimbursed drug therapy modifications.
Results: Claims were paid to pharmacists for drug therapy modifications to allow tablet splitting, drug therapy changes, and switching noncovered drugs. Tablet splitting provided the largest cost savings to the PBM, accounting for slightly more than one-third of the claims and representing more than one-half of the prescription fills. Switching drugs not covered provided the largest cost savings to patients. Overall, the PBM saved a mean of $20.31 per prescription fill, and patients saved $14.76 per prescription fill. Mean overall ROI to the PBM was 3.55.Other authors -
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Description and preliminary outcomes of a medicare part D medication therapy
JPSW September/October 2007:8-10.
The first year of Medicare Part D's medication therapy management program at a midwest PBM identified a high number of drug therapy problems. A pharmacist intervention resulted in communication of these drug related problems to the beneficiary's prescriber and education of the beneficiary in the safe and effective use of medications.
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Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program
Health Promot Pract. 2007 July ; 8(3): 282–291.
This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthma nurse case manager. The…
This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthma nurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the yearlong integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised.
Other authorsSee publication -
Comparison of Outcomes Using 2 Delivery Models of Anticoagulation Care
Arch Intern Med. 2006;166:997-1002
Background: Studies demonstrate the effectiveness of anticoagulation management service (AMS) in providing antithrombotic therapy for eligible patients. We sought to extend this concept by determining whether an interim telephone model (IT) is comparable to our current AMS model at achieving optimal therapeutic outcomes.
Methods: The 36-month trial (24-month study plus 12-month extension) enrolled 192 eligible patients receiving long-term warfarin therapy at a Veterans Affairs hospital…Background: Studies demonstrate the effectiveness of anticoagulation management service (AMS) in providing antithrombotic therapy for eligible patients. We sought to extend this concept by determining whether an interim telephone model (IT) is comparable to our current AMS model at achieving optimal therapeutic outcomes.
Methods: The 36-month trial (24-month study plus 12-month extension) enrolled 192 eligible patients receiving long-term warfarin therapy at a Veterans Affairs hospital. Consenting participants were randomly assigned to either our current face-to-face clinic model (AMS), or our IT model. The primary outcome was the percentage of time individuals’ international normalized ratios (INRs) were maintained within their target INR range (2.0-3.0
or 2.5-3.5). Secondary outcomes included the number of adverse events (eg, thromboembolism or hemorrhage) experienced during the study.
Results: We found no statistically significant difference between the 2 groups in the percentage of time maintained within INR target range overall (55.1% for AMS; 57.8% for IT; P=.28) nor over the course of the study. There were no statistically significant differences in the rate of thromboembolic or serious bleeding events between IT and AMS participants. Nevertheless, we did note differences related to intensity of anticoagulation. The IT group receiving treatment at a higher intensity (INR, 2.5-3.5) experienced greater anticoagulation control (P=.04) and fewer complications than the AMS group. The IT participants, however,
reported a significantly higher rate of minor bleeding events, experienced mainly by those at an INR range of 2.0 to 3.0.
Conclusion: Our IT model is a viable modification of our AMS model for the management of patients undergoing chronic anticoagulant therapy.Other authors -
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Use of the modified Delphi technique to identify and rate home injury hazard risks and prevention methods for young children
Injury Prevention 2006;12:189–194. doi: 10.1136/ip.2005.010504
Objective: For children aged 1–5 years, the authors used the Delphi method to determine (1) the most important injury hazards in each area of the home; (2) the most important injury prevention behaviors; and (3) feasible and efficacious safety devices and behaviors to reduce injury risks.
Results: The overall response rate for each survey ranged from 82% to 97%. Initially, 330 unique hazards and prevention behaviors/devices were identified in seven areas of the home. The 126 home injury…Objective: For children aged 1–5 years, the authors used the Delphi method to determine (1) the most important injury hazards in each area of the home; (2) the most important injury prevention behaviors; and (3) feasible and efficacious safety devices and behaviors to reduce injury risks.
Results: The overall response rate for each survey ranged from 82% to 97%. Initially, 330 unique hazards and prevention behaviors/devices were identified in seven areas of the home. The 126 home injury hazards were rated based on frequency, severity, and preventability of injury; and the 204 behaviors and devices were rated by efficacy and feasibility. These experts rated firearms and pools as the most significant hazards, and smoke alarms and safe water temperature as the most important preventions.Other authors -
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Validating self reported home safety practices in a culturally diverse non-inner city population
Injury Prevention 2006;12:52–57. doi: 10.1136/ip.2005.009399
Objective: To determine the validity of face to face, self reported responses to questions about the presence of safety devices and use of safety practices in the home aimed at preventing unintended injuries to preschool aged children.
Conclusions: Use of safety devices and practices by parents of preschool aged children reported in a face to face interview are generally reliable. Reliability increases if the interview is conducted in the home. Parents may also be more willing to report…Objective: To determine the validity of face to face, self reported responses to questions about the presence of safety devices and use of safety practices in the home aimed at preventing unintended injuries to preschool aged children.
Conclusions: Use of safety devices and practices by parents of preschool aged children reported in a face to face interview are generally reliable. Reliability increases if the interview is conducted in the home. Parents may also be more willing to report potential problems if they perceive they may receive corrective assistance.Other authors -
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Education is not enough: equipment and legislation are also needed to
Wisconsin Medical Journal 2005;104(2):17-18.
Invited Guest Editorial to discuss child passenger safety in vehicles. Inspiration of the article arose from personal experiences while also working on a Department of Housing and Urban Development grant as part of the Health Homes Initiative.
Projects
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Pharmacy Network Redesign
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Successful narrowing of the retail pharmacy network was undertaken and achieved. Member disruption was managed and resolved. Vital to the success of the pharmacy network redesign was retaining access to a broad independent community pharmacy network. Supporting the patient-pharmacy relationship was essential while also improving cost savings to plan sponsors and members.
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Remicade Biosimilar Conversion
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Dean Health Plan was one of a small handful of health plans to proactively undertake an infliximab biosimilar conversion. Recall, this was a time when biosimilars were just entering the marketplace at scale. Significant coordination and partnership with providers and health system pharmacists was essential in this successful conversion.
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HPV Vaccination Improvement Project—NCQA
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Completion of the HPV series in eligible members was suboptimal. A coordinated effort between the pharmacy department, the quality department, and PBM developed an incentive program that significantly improved the HPV vaccine series completion rates.
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Mail Order Pharmacy and Benefit Enhancements
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A mail order pharmacy benefit enhancement was developed and implemented in order to provide members with choice in where they fill their prescriptions. In order to support local community pharmacies a 90-day retail program was enhanced as well.
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Optimization of Formulary Management using RxFlex software by AdaptiveRx
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Managing multiple drug lists and formularies for both commercial and government programs can be a daunting task. Keeping the formularies PBM agnostic provides health plans the ultimate control over their pharmacy benefit goals and objectives. We are using RxFlex a formulary management software solution provided by AdaptiveRx. Great people to work with and slick interface and integration with key PBM partners. Making a formulary change across formularies is simple with a few clicks.
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Formulary Management and Provider Education
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Making a formulary change is difficult because many people can be affected by the change. In April 2013 our pharmacy department presented good opportunities to improve access by members to a new oral anticoagulant called Xarelto (Rivaroxaban) because there remain members unable to use warfarin (the lower cost, effective alternative). The challenge is to raise provider awareness. Our communication plan was developed with both patients and health care providers in mind with the goal of increasing…
Making a formulary change is difficult because many people can be affected by the change. In April 2013 our pharmacy department presented good opportunities to improve access by members to a new oral anticoagulant called Xarelto (Rivaroxaban) because there remain members unable to use warfarin (the lower cost, effective alternative). The challenge is to raise provider awareness. Our communication plan was developed with both patients and health care providers in mind with the goal of increasing quality care and improve health outcomes.
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Languages
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English
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Croatian
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