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Efficacy of a centralized medication therapy management team to improve medication outcomes
Abstracts / Research in Social and Administrative Pharmacy 12 (2016) e1–e9 statin use according to the ACC/AHA guidelines. The primary outcome of our study is the percent change in the number of patients appropriately prescribed a statin. Results/Outcomes: Data collection is ongoing. Preliminary data analysis estimates that 44% of study patients were appropriately prescribed a statin in November 2014, prior to the start of clinical pharmacy services. Data collection will be completed in January of 2016. Implications for Pharmacy Practice/Healthcare: Appropriate statin prescribing benefits the health of patients and lowers costs for payers and providers. This study will help pharmacists determine how best to implement clinical pharmacy services in a primary care setting.
The Balanced Adherence Metric (BAM): a new spin on current methods for calculating adherence with pharmacy claims data B. Simpson, A. Adler, McMaster University/ MEMOTEXT Purpose/Objectives: While Proportion of Days Covered (PDC) quantifies adherence (from claims data) in patients with complex regimens, it may not accurately quantify other important dimensions of adherence. Single interval adherence (eg. Medication Possession Ratio) and refill timing behaviour (delay to refill) also provide meaningful information. Our objective was to combine them into a single metric which would account for these additional facets of adherence, but presented using a single value that was simple to interpret. Methods: Nine months of pharmacy claims data from 4780 patients with hypertension, high cholesterol or both was used. PDC, MPR and Delay to Refill were calculated using the statistical package R. Delay to Refill was expressed as the proportion of time patients refilled their prescriptions early/on time. Results: The mean PDC and MPR were near or within the optimal range (PDC ¼ 73.9%, MPR¼ 90.6%). Patient refills were early/on time an average of 37.0% of the time. Together these metrics suggested that patients were adherent over the study interval, but we often refilling their prescriptions late. This poor adherence behaviour was not evident from inspection of the PDC and MPR distributions. In an effort to unify these metrics, we computed the weighted geometric mean of all three metrics (termed the Balanced Adherence Metric). The resulting metric showed a bimodal distribution of adherence, with a mean of 68.0%. Implications for Pharmacy Practice/Healthcare: Our study has shown that a mathematical combination of currently available adherence metrics may be more beneficial than either metric alone in objectively assessing adherence. Interpretation of the BAM is identical to that of PDC and it is simple to calculate with modern statistical software. The BAM and other similar weighted metrics may provide a more accurate and complete picture of adherence derived from claims data.
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Effectiveness of a centralized medication therapy management team to improve medication outcomes E.S. Burke, PharmD, BCACP, K. Niles, PharmD, J. DiNicolantonio, PharmD, C. Gardiner, PharmD, K. Conn, PhD, MPH, Wegmans/ St. John Fisher College Wegmans School of Pharmacy Purpose/Objectives: To evaluate the effect of centralized medication therapy management (MTM) services on patient care in a regional community pharmacy chain. Methods: Wegmans pharmacy created a centralized team of pharmacy interns and pharmacists to provide medication therapy management services. The team provides MTM services, including comprehensive medication reviews (CMRs) and targeted interventions, for all 88 locations. Additionally, the central team provides education and support to store level pharmacists to allow MTM services to be provided in the stores whenever possible. The service was evaluated using national quality measure benchmarks including CMR completion rate, proportion of days covered (PDC) for statins, oral diabetes and renin-angiotensin system agents and appropriate use of statins in patients with diabetes. Results: Efficacy of the centralized model was assessed by comparing the CMR completion rate, adherence to select agents and appropriate use of statins in patients with diabetes before implementation and after 1 year. Final results of this project are expected April 2016. Implications for Pharmacy Practice/Healthcare: With increased emphasis on quality measures improvement, community pharmacists are faced with balancing medication management and continued dispensing responsibilities; additional methods to provide safe and effective care are needed. Centralizing clinical services may reduce the burden on pharmacists providing services in the store allowing them to focus on patients who will most benefit from in person medication management services. Using pharmacy quality measures in Medicaid drug utilization review programs B. Banahan III, S. Hardwick, S. Noble, J. Clark, University of Mississippi Purpose/Objectives: The Affordable Care Act created the National Quality Strategy and increased quality improvement efforts in Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) maintains adult and child core measurement sets for voluntary reporting by state programs. Only a few pharmacy-related measures are included in the core sets. The Pharmacy Quality Alliance (PQA) and other organizations have proposed and/or developed additional measures that are appropriate for Medicaid programs. Recent CMS notices indicate that drug utilization review (DUR) programs will be expected to take more active roles in quality improvement in the future. A major objective of the Mississippi Medicaid DUR (MS-DUR) during the last few years has been to
The Balanced Adherence Metric (BAM): a new spin on current methods for calculating adherence with pharmacy claims data B. Simpson, A. Adler, McMaster University/ MEMOTEXT Purpose/Objectives: While Proportion of Days Covered (PDC) quantifies adherence (from claims data) in patients with complex regimens, it may not accurately quantify other important dimensions of adherence. Single interval adherence (eg. Medication Possession Ratio) and refill timing behaviour (delay to refill) also provide meaningful information. Our objective was to combine them into a single metric which would account for these additional facets of adherence, but presented using a single value that was simple to interpret. Methods: Nine months of pharmacy claims data from 4780 patients with hypertension, high cholesterol or both was used. PDC, MPR and Delay to Refill were calculated using the statistical package R. Delay to Refill was expressed as the proportion of time patients refilled their prescriptions early/on time. Results: The mean PDC and MPR were near or within the optimal range (PDC ¼ 73.9%, MPR¼ 90.6%). Patient refills were early/on time an average of 37.0% of the time. Together these metrics suggested that patients were adherent over the study interval, but we often refilling their prescriptions late. This poor adherence behaviour was not evident from inspection of the PDC and MPR distributions. In an effort to unify these metrics, we computed the weighted geometric mean of all three metrics (termed the Balanced Adherence Metric). The resulting metric showed a bimodal distribution of adherence, with a mean of 68.0%. Implications for Pharmacy Practice/Healthcare: Our study has shown that a mathematical combination of currently available adherence metrics may be more beneficial than either metric alone in objectively assessing adherence. Interpretation of the BAM is identical to that of PDC and it is simple to calculate with modern statistical software. The BAM and other similar weighted metrics may provide a more accurate and complete picture of adherence derived from claims data.
e5
Effectiveness of a centralized medication therapy management team to improve medication outcomes E.S. Burke, PharmD, BCACP, K. Niles, PharmD, J. DiNicolantonio, PharmD, C. Gardiner, PharmD, K. Conn, PhD, MPH, Wegmans/ St. John Fisher College Wegmans School of Pharmacy Purpose/Objectives: To evaluate the effect of centralized medication therapy management (MTM) services on patient care in a regional community pharmacy chain. Methods: Wegmans pharmacy created a centralized team of pharmacy interns and pharmacists to provide medication therapy management services. The team provides MTM services, including comprehensive medication reviews (CMRs) and targeted interventions, for all 88 locations. Additionally, the central team provides education and support to store level pharmacists to allow MTM services to be provided in the stores whenever possible. The service was evaluated using national quality measure benchmarks including CMR completion rate, proportion of days covered (PDC) for statins, oral diabetes and renin-angiotensin system agents and appropriate use of statins in patients with diabetes. Results: Efficacy of the centralized model was assessed by comparing the CMR completion rate, adherence to select agents and appropriate use of statins in patients with diabetes before implementation and after 1 year. Final results of this project are expected April 2016. Implications for Pharmacy Practice/Healthcare: With increased emphasis on quality measures improvement, community pharmacists are faced with balancing medication management and continued dispensing responsibilities; additional methods to provide safe and effective care are needed. Centralizing clinical services may reduce the burden on pharmacists providing services in the store allowing them to focus on patients who will most benefit from in person medication management services. Using pharmacy quality measures in Medicaid drug utilization review programs B. Banahan III, S. Hardwick, S. Noble, J. Clark, University of Mississippi Purpose/Objectives: The Affordable Care Act created the National Quality Strategy and increased quality improvement efforts in Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) maintains adult and child core measurement sets for voluntary reporting by state programs. Only a few pharmacy-related measures are included in the core sets. The Pharmacy Quality Alliance (PQA) and other organizations have proposed and/or developed additional measures that are appropriate for Medicaid programs. Recent CMS notices indicate that drug utilization review (DUR) programs will be expected to take more active roles in quality improvement in the future. A major objective of the Mississippi Medicaid DUR (MS-DUR) during the last few years has been to