Medication therapy disease management: Geisinger’s approach to population health management

Jones, Laney K.; Greskovic, Gerard A.; Grassi, Dante M.; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R.; Murray, Michael F.; Manickam, Kandamurugu; Nathanson, Douglas C.; Wright, Eric A.; Evans, Michael A.

doi:10.2146/ajhp161061

Cited by 30 publications

(18 citation statements)

References 34 publications

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“…Another limitation is the unknown generalizability of the MTDM program beyond Geisinger. Although the MTDM program was designed to be scalable and generalizable, 20 future studies are needed to examine the feasibility of similar MTDM programs elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost

Maeng¹,

Graham²,

Bogart³

et al. 2018

CEOR

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PurposePharmacist-led medication therapy disease management (MTDM) has shown improvement in clinical outcomes in patients with certain chronic diseases. However, only limited data demonstrating the impact on health care utilization and cost of care are available. This study seeks to evaluate the impact of a pharmacist-led MTDM program on clinical surrogate outcomes, care utilization, and cost of care among patients with diabetes mellitus.MethodsA retrospective cohort study was conducted by utilizing electronic health records and insurance claims data. Patients were identified between February 2011 and December 2014. Data were collected from Geisinger, a large integrated health care system located in Pennsylvania and southern New Jersey. A total of 5,500 patients with diabetes mellitus were identified; 2,750 were enrolled in MTDM and were 1-to-1 propensity score-matched to a comparison cohort not enrolled in a pharmacist-led MTDM program.ResultsThere were no differences between groups in composite HbA1c, blood pressure, or low-density lipoprotein cholesterol goal attainment at 12 months (12% vs 12%, P=0.53). HbA1c goal was reached more frequently among patients without MTDM compared to those at 12 months (57% vs 51%, P<0.0001). There were no significant differences between the two cohorts in the attainment of blood pressure or low-density lipoprotein cholesterol goals at 12 months. MTDM was associated with reduced all-cause hospitalization rate (−19.6%; P=0.02) as well as increased primary care physician visits (18.5%; P<0.001) and lower average per-member-per-month medical cost (−13%, P=0.027).ConclusionDespite the lack of impact on the clinical surrogate outcomes, MTDM was associated with lower cost of care and fewer hospitalizations, possibly facilitated by increased monitoring (ie, higher primary care utilization).

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Section: Discussionmentioning

confidence: 99%

Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost

Maeng¹,

Graham²,

Bogart³

et al. 2018

CEOR

Self Cite

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“…Many opportunities for collaborative practice exist for all clinical pharmacists within existing provider practice models; yet clinical pharmacists will be called to prove their value in cost avoidance, patient experience, and clinical outcome metrics to substantiate their salary. It can be done but does require time to show outcomes 22 …”

Section: Planning For and Implementation Of The Icu‐rc Clinical Pharmmentioning

confidence: 99%

“…Efforts to optimize care transitions are paramount as models of care are redesigned to emphasize home‐based care. Clinical pharmacists in ICU‐RCs are uniquely poised to play a pivotal role in this transition 22,57 …”

Section: Planning For and Implementation Of The Icu‐rc Clinical Pharmmentioning

confidence: 99%

“…Clinical pharmacists, especially critical care clinical pharmacists, 18‐20 practicing in this setting contribute an important skill set to appropriately assess potential MRPs, address PICS, assist with medication procurement issues, and educate patients on their medication‐related issues. As pharmacotherapeutic experts, clinical pharmacists are uniquely poised to perform high quality medication reconciliation accompanied by real time medication therapy recommendations and regimen modifications to promote medication safety and adherence 4,21,22 …”

Section: Introductionmentioning

confidence: 99%

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Clinical pharmacist services within intensive care unit recovery clinics: An opinion of the critical care practice and research network of the American College of Clinical Pharmacy

Mohammad

Betthauser

Korona

et al. 2020

J Am Coll Clin Pharm

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Intensive care unit recovery clinics (ICU‐RCs) have been proposed as a potential mechanism to address the multifaceted unmet needs of intensive care unit (ICU) survivors and caregivers. The needs of this population include, but are not limited to, medication optimization, addressing physical function and psychological needs, coordination of care, and other interventions that may help in improving patient recovery and reducing the rate of preventable readmissions. The objective of this opinion paper is to identify and describe clinical pharmacy services for the management of ICU survivors and their caregivers in an ICU‐RC. The goals are to guide the establishment and development of clinical pharmacist involvement in ICU‐RCs and to highlight ICU recovery research and educational opportunities. Recommendations provided in this paper are based on the following: a review of published data on clinical pharmacist involvement in the ICU‐RCs; a consensus of clinical pharmacists who provide direct patient care to ICU survivors and caregivers; and a review of published guidelines and literature focusing on the management of ICU survivors and caregivers. These recommendations define areas of clinical pharmacist involvement in ICU‐RCs. Consequently, clinical pharmacists can promote education on Post Intensive Care Syndrome and Post Intensive Care Syndrome‐Family; improve medication adherence; facilitate appropriate referrals to primary care providers and specialists; ensure comprehensive medication management and medication reconciliation; provide assessment of inappropriate and appropriate medications after hospitalization; address adverse drug events, medication errors, and drug interactions; promote preventive measures; and facilitate medication acquisition with the goal of improving patient outcomes and reducing health care system costs.

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“…Pharmacists have also shown benefit in several chronic disease states. For patients with atrial fibrillation, MTM services decreased emergency department visits, hospitalizations, and annual total care costs [ 5 ]. For patients with end stage renal disease, pharmacist interventions are estimated to save $3.98 for every $1 spent on pharmaceutical care [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

From Pilot to Scale, the 5 Year Growth of a Primary Care Pharmacist Model

Spillane

Smith

2020

Pharmacy

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This case report details the five year journey of implementing, growing and optimizing a primary care pharmacist model in the ambulatory clinic setting within a health system. There is published evidence supporting the numerous benefits of including pharmacists in the primary care medical team model. This case report provides information regarding evolution of practice, the pharmacists’ roles, justification and financial models for the pharmacist services, as well as lessons learned and determined conclusions.

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Medication therapy disease management: Geisinger’s approach to population health management

Cited by 30 publications

References 34 publications

Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost

Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost

Clinical pharmacist services within intensive care unit recovery clinics: An opinion of the critical care practice and research network of the American College of Clinical Pharmacy

From Pilot to Scale, the 5 Year Growth of a Primary Care Pharmacist Model

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