seniors' medication study

8/8/2019 Seniors' Medication Study

1/3

ALZHEIMERS DRUG THERAPY INITIATIVE

Seniors Medication Study Recruitment ends March 31, 2011

Dear Physician: Pharmaceutical Services is currently providing physicians with a list of their patients inthe Alzheimers Drug Therapy Initiative (ADTI) to help identify possible referrals to theSeniors Medication Study (SMS). We are now looking for ChEI-nave patients whostarted treatment during the last 12 months.

The results of the SMS will improve physician understanding of how these medicationsaffect Alzheimers patients, their families and the impact on B.C.s health care systemand help inform the validity of the SMMSE. It is easy to participate in the SMS. After a patient receives ADTI Special Authorityapproval, your involvement as physician is limited to submitting the attached SMSReferral Fax and three Clock-Drawing Tests over the course of 18 months. Once thereferral is made, you will be notified by fax when your patient is accepted into the SMS. To compensate you for your time spent participating in the research, MSP fees areavailable (see attached fee items). If you have any questions, please contact the Seniors Medication Study researcherstoll free at 1 866 511-2594 or 250 721-6574 or by email to [email protected] . Please note: ChEI coverage through the ADTI will continue after March 2011;physicians can continue registering and re-registering their patients for coverageuntil March 2012. _____________________________________________________
mailto:[email protected]:[email protected]:[email protected]


2/3

MSP FEE ITEMS FOR THE

SENIORS MEDICATION STUDY

97004 Patient Referral to the Seniors Medication Study(submit Referral Fax to University of Victoria StudyOffice estimated time to complete 1 to 2 minutes)

$50

97006 Patient Assessment at 6, 12 and 18 months (submitClock Drawing Test to UVic Study Office - estimatedtime to complete - 3 to 5 minutes)

$50

97007 Inform Study Office when patient stops medication(submit Medication stop fax to UVic Study Office -estimated time to complete - up to 3 minutes)

$15


3/3

MSP CLAIM 97004

From:

Physician Billing Number (MSP): _______________________________________________________________

Physician providing follow-up care (if different): __________________________________________________

* Please note: no other study documents are required with the Referral Fax; the Study Office will mail further study documents before the next follow-up visit.

Re: The patient and caregiver have indicated an interest in receiving more information about the study, andto agree to have their contact information forwarded to the Study Team.

Questions: Myriam Gerber Hedge, Project Administrator SMSChelsie Kadgien, Interview Supervisor CS 1-866-511-2594

Concerns about ethics: Call the UVic Office of Research Services at 250-472-4545

Referral Fax * P A T I E N T & C A R E G I V E R R E F E R R A L

Physician Name (office stamp or fill in) :

Patient Name:Patient Address:

Patient Phone:Care Card Number:

Caregiver Name:

Caregiver Phone:

Please Fax To: 1-250-853-3799

seniors' medication study

Documents