Final Research Report
View this project's final research report.
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Using an Online Decision Support Tool to Assist with Medicare Part D Selections
Principal Investigator Mary Bundorf describes her project, which created and tested an online decision support tool to assist patients with their Medicare Part D selections.
Article Highlight: People who enroll in Medicare Part D, which covers prescription medicines, must choose a plan, but many people struggle to make an informed choice. Researchers on this study created a decision aid to help people choose among the options based on what is most important to them. They then tested whether the decision aid, with or without machine-based, personalized expert recommendations, influenced outcomes for Medicare Part D enrollees. Results published in Health Affairs show that patients who used the decision aid reported increased satisfaction with the process of choosing a prescription drug plan and the amount of time they spent choosing a plan.
Results of This Project
Related Journal Citations
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:
- Reviewers asked for additional information about the selection of 1,185 people in the original study sample from the 29,000 originally eligible for the study. They noted that there were limitations that should be noted in the report regarding the use of passive recruitment strategies that required participants to contact investigators rather than researchers actively recruiting participants. In particular, this recruitment strategy may have led to sampling bias, where the participants were not truly representative of the population. The researchers explained that given their short study enrollment period, they believed this passive enrollment strategy to be the most effective way of achieving an adequate study sample. They also believed that a more active recruitment strategy would not have been feasible.
- Reviewers repeatedly expressed concern about the study’s lack of generalizability to a wide segment of the Medicare population since patients in all phases of this study were predominantly Caucasian and highly educated. The researchers responded, indicating the demographic characteristics of study participants more prominently in the report. They also expanded their discussion of the potential sampling bias in relation to study generalizability as well as study limitations.
- Reviewers asked whether the study attempted to assess whether family members assisted participants in using the project’s web-based tool. The researchers said they neither encouraged nor discouraged participants from seeking help in using the website. However, they found in a final survey that 15 percent of participants reported receiving some assistance from family members or friends. There were no significant differences between study arms in the percent of participants receiving such assistance.
- Reviewers suggested that it would have been interesting to stratify focus group and ethnographic results based on a number of key themes and participant characteristics. The researchers agreed that this would be interesting but explained that they did not link exit survey data with qualitative results. Therefore, the researchers stated that they could not stratify results by patient characteristics because of the way they collected data.
Conflict of Interest Disclosures
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