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Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan
Abstract:
OBJECTIVE: To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees.
DESIGN: Before/after design with two control groups.
SETTING: Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005.
PARTICIPANTS: 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups.
INTERVENTIONS: Pharmacist-conducted MTM reviews for volunteering patients.
MAIN OUTCOME MEASURES: Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services).
RESULTS: Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service.
CONCLUSION: A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease education associated with problem detection and resolution. Patient satisfaction levels with the service were very high.
Type of Article: Primary Intervention Research
Disease states: Multiple
Clinical services: Medication Therapy Management
Monitoring values studied:
Type and frequency of drug therapy problems detected and services performed; Number and cost of medications dispensed; Patient satisfaction
General objectives:
The objective of this article was to assess a pharmacist-based medication therapy management (MTM) service for the types of drug therapy problems identified and patient satisfaction with the program.
General results:
Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service.
Health outcome objectives:
Not available
Health outcome results:
Not available
Economic objectives:
The economic objective of this article was to evaluate the impact of a pharmacist-based medication therapy management (MTM) service on the number and cost of prescriptions dispensed.
Economic results:
The MTM program did not necessarily result in reductions in prescription drug use or cost
Pharmacies studied: Not identified
Type of pharmacy: Not available
Region(s): United States - South
Environments(s): Not available
Country: United States of America
State: North Carolina
City: Not identified
Notes: None
Full citation: Christensen DB, Roth M, Trygstad T, Byrd J. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan. J Am Pharm Assoc (2003). 2007;47(4):471-483.
Publication: Journal of the American Pharmacists Association
Published: 2007
MeSH terms: Adult; Aged; Community Pharmacy Services (economics); Disease Management; Drug Therapy (adverse effects); Humans; Medicare (legislation & jurisprudence); Middle Aged; North Carolina; Patient Satisfaction; Pharmacies; Pharmacists; Pilot Projects; Professional Role; Research Design; State Health Plans; United States
PMID: 17616493