Evaluation of Medication Therapy Management Services for Patients with Cardiovascular Disease in a Self-Insured Employer Health Plan

Abstract

BACKGROUND: Cardiovascular disease (CVD) is a major cause of mortality in the United States, representing the highest total expenditures among major diseases. To improve CVD-associated outcomes, medication therapy management (MTM) services have been included in essential health benefit packages offered by various health plans. Nevertheless, the impact of such MTM services on outcomes is still unclear, especially from the perspective of the self-insured employer.

Understanding Reasons for Nonadherence to Medications in a Medicare Part D Beneficiary Sample

“…[17][18][19][20][21][22] Additionally, pharmacist services (e.g., MTM and patient education) decrease hospital admissions (up to 30%), 23,24 emergency department visits (up to 24%), 24,25 and overall health care expenditures. 26,27 Despite these efforts, 4%-40% of all Medicare beneficiaries are nonadherent to prescribed medication regimens. 28,29 Several instruments measure medication adherence and patients' beliefs about their medications.…”

Medication Therapy Management Programs: Promises and Pitfalls

“…A major limitation, as the authors noted, was self-selection, which may add bias to the results. Another limitation in this study and in the Wittayanukorn et al study 23 may lie in the need for more appropriately controlled variables in multivariate analyses to address the bias introduced by the nonrandomized group assignment (e.g., baseline ED visits, diabetes, and depression).…”

“…22 However, the lack of control groups is a major limitation of this study. Wittayanukorn et al (2013) conducted a match-paired (age, gender, disease, and comorbidity) cohort study to compare economic outcomes of MTM services (n = 63, mean age 56.8) with that of non-MTM usual care (n = 63, mean age 56.9) for patients with cardiovascular disease (CVD). 23 The MTM group received MTM services at a pharmacist-provided pharmaceutical care patient on total mean annual health care in pilot pharmacies patients than in other pharmacies.…”

“…Wittayanukorn et al (2013) conducted a match-paired (age, gender, disease, and comorbidity) cohort study to compare economic outcomes of MTM services (n = 63, mean age 56.8) with that of non-MTM usual care (n = 63, mean age 56.9) for patients with cardiovascular disease (CVD). 23 The MTM group received MTM services at a pharmacist-provided pharmaceutical care patient on total mean annual health care in pilot pharmacies patients than in other pharmacies. 21 Bunting et al (2008) evaluated a community-based longterm MTM program for persons with hypertension and dyslipidemia who received education and long-term MTM.…”

Assessing Feasibility of Delivering Pharmacogenetic Testing in a Community Pharmacy Setting

“…Though practices can vary [28], MTM services typi cally include five core elements: medication therapy review; personal medication record; medication action plan (MAP); intervention and/or referral; and docu mentation and followup [29]. MTM has been effec tive for some patient populations in reaching clinical goals, increasing compliance with recommended lab monitoring, reducing rehospitalizations and inap propriate prescribing and risk of adverse drug reac tions, and improving adherence [6,[30][31][32][33][34][35][36]. Because of its effectiveness, MTM is a service covered by insurance companies and the Medicare program in the USA [37].…”