Comprehensive Medication Therapy Management: Identifying and Resolving Drug-Related Issues in a Community Pharmacy

Doucette, William R.; McDonough, Randal P.; Klepser, Donald G.; McCarthy, Renee

doi:10.1016/s0149-2918(05)00146-3

Cited by 128 publications

(119 citation statements)

References 27 publications

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“…These results are consistent with those of previous research that assessed the clinical outcomes of pharmaceutical care services. 19,31,39,40 For example, Welch et al found that Medicare Part D beneficiaries who opted in to receive MTM were more likely to incur an increase in medication costs than were those who opted out of MTM. 19 These results also indicate that health care providers might choose nonpharmacological interventions when drug therapy is needed or use a dose that is too low to control the patient's medical condition.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Medication Therapy Management: 10 Years of Experience in a Large Integrated Health Care System

Oliveira¹,

Brummel²,

Miller³

2010

JMCP

284

315

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BACKGROUND: Medication therapy management (MTM) was officially recognized by the federal government in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which requires Medicare Part D plans that offer prescription drug coverage to establish MTM programs (MTMPs) for eligible beneficiaries. Even though the term "MTM" was first used in 2003, pharmacists have provided similar services since the term "pharmaceutical care" was introduced in 1990. Fairview Health Services, a large integrated health care system, implemented a standardized pharmaceutical care service system in 1998, naming it a pharmaceutical care-based MTM practice in 2006.

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Section: Clinical Outcomesmentioning

confidence: 99%

Medication Therapy Management: 10 Years of Experience in a Large Integrated Health Care System

Oliveira¹,

Brummel²,

Miller³

2010

JMCP

284

315

View full text Add to dashboard Cite

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“…The 69.7% acceptance rate of recommendations by physicians was higher than in many published outpatient studies. 23,24,26,34 This outcome may have been attributable to the use of only 1 person, the clinical pharmacist who performed the intervention, to determine the acceptance rate in each of the 2 study groups. However, the relationships built between the clinical pharmacist and physicians in the intervention group over the 12 months probably played a role in the success of the inter vention as demonstrated in other studies in which authors surmised that interpersonal relationships between the pharmacist and physicians contributed to improved outcomes.…”

Section: Limitationsmentioning

confidence: 99%

A Prospective Trial of a Clinical Pharmacy Intervention in a Primary Care Practice in a Capitated Payment System

Altavela¹,

Jones²,

Ritter³

2008

JMCP

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BACKGROUND: There is evidence that pharmacist interventions improve clinical outcomes. The few studies that address economic outcomes (a) often report estimated instead of actual medical costs, (b) report only medication costs, or (c) have been conducted in settings that are not typical of community-based primary care.OBJECTIVES: To (a) determine whether a clinical pharmacist's recommendations to physicians regarding optimizing medication therapy are related to medical costs in capitated patients in an internal medicine practice, and (b) compare what primary care physicians (PCPs) in a comparison group actually did proactively to optimize medication therapy versus what a clinical pharmacist would have recommended to them.METHODS: This was a prospective, controlled study comparing 2 internal medicine practices. Study enrollment was performed using a screening process carried out every 1-2 weeks on a rolling basis for 1 year from July 2001 through June 2002. Eligibility criteria for prospective enrollment were (a) 1 or more risk factors: at least 1 chronic disease or an event (e.g., emergency room visit, adverse drug reaction, medication nonadherence) or aged 50 years or older, (b) a scheduled visit to see a PCP within 2 weeks from the screening date or a diagnosis of diabetes without a PCP visit during the first 6 months of the study, (c) need for optimization of medication therapy as determined by a clinical pharmacist on the screening date, and (d) 12 months of continuous insurance eligibility before enrollment in the study. For inclusion in the final study analyses, patients were also required to have continuous insurance eligibility through 12 months from study enrollment. One clinical pharmacist made recommendations to optimize medication therapy in the intervention group. For the comparison group, the same pharmacist proposed recommendations that remained concealed from the physicians. The primary outcome measure was per patient per year (PPPY) medical cost, based on plan liability (gross allow able costs minus patient costs), excluding prescription drug cost. Additional outcome measures included numbers of outpatient visits, hospital admissions, emergency room (ER) visits per 1,000 patients, and hospital days; and percent of recommendations that were accepted by the PCPs. Changes in outcome measures from the pre-intervention to postintervention period were compared across study groups in a difference-indifference analysis, using the Student's t-test for normally distributed data and the Mann-Whitney U-test (nonparametric) for skewed data.RESULTS: There were 127 and 216 adult patients in the intervention and comparison groups, respectively. The primary outcome, change in mean PPPY medical (excluding pharmacy) cost, did not differ significantly between the groups (P = 0.711). The between-group difference in the change in ER visits per 1,000 patients approached statistical significance (P = 0.054). Intervention group patients were more likely than comparison group patients to have the following issues...

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“…Given their relatively recent recognition as providers of preventative services, [5][6][7] pharmacists, like other healthcare professionals, will now be expected to play an active role in the public health arena. Accordingly, training pharmacists as public health providers will need to become a central part of their curriculum.…”

Section: Introductionmentioning

confidence: 99%

Pharmacy Students’ Attitudes Toward a Required Public Health Course and Developing a Public Health Program

Shah¹,

Rahim²,

Yin³

et al. 2009

Am J Pharm Educ

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Objective. To determine pharmacy students' attitudes towards a required public health course and developing a public health program. Method. Two hundred ten first-year pharmacy students enrolled in a public health course at a large private pharmacy school were surveyed. A 24-item adjective rating scale and a 10-item scale were used to measure students' attitudes towards the course and developing a public health program. Results. Of 198 respondents, two-thirds found the course to be extremely or very appealing, of practical value, and only slightly demanding and difficult. The majority of the students indicated that establishing a public health program would be an opportunity to help the community and make a difference. Few students indicated that it would be a poor use of time or an example of busy work. Conclusion. Pharmacy students had positive attitudes towards a required public health course and developing a public health program. Strategies to mold positive attitudes into actual behaviors of engaging in public health activities are needed.

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Comprehensive Medication Therapy Management: Identifying and Resolving Drug-Related Issues in a Community Pharmacy

Cited by 128 publications

References 27 publications

Medication Therapy Management: 10 Years of Experience in a Large Integrated Health Care System

Medication Therapy Management: 10 Years of Experience in a Large Integrated Health Care System

A Prospective Trial of a Clinical Pharmacy Intervention in a Primary Care Practice in a Capitated Payment System

Pharmacy Students’ Attitudes Toward a Required Public Health Course and Developing a Public Health Program

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