Medication Therapy Management for Texas MediCAID Patients With Asthma and Chronic Obstructive Pulmonary Disease—A Pilot Study

Abstract

Background: Pharmacists can play an important role in providing medication therapy management (MTM) services, which focus on appropriate medication use. This pilot study aimed to describe pharmacists’ MTM service provision, results/outcomes of pharmacists’ recommendations and resolution/acceptance rate among patients with high-risk asthma and/or chronic obstructive pulmonary disease (COPD). Methods: This was a prospective descriptive study of MTM services provided by community pharmacists to Texas Medicaid patients (5-63 years) with “high risk” asthma or COPD. Patients received in-person and telephone consultations that included medication review, asthma control test assessment, and education on adherence and proper medication/device use. Data extracted from MTM software was used to describe: reasons for MTM services, type of pharmacists’ interventions, outcomes of pharmacists’ recommendations and acceptance rate. Results: Twenty-eight pharmacists provided 139 MTM interventions with 63 patients (2.2 interventions per patient). The most frequent intervention reason was complex drug therapy (53.2%), underuse of medication (8.6%), need for drug therapy (8.6%), new or changed prescription therapy (6.5%), and administration technique (5.0%). The resolution rate was 77.7%. Patient and prescriber, respectively, refused recommendation in 12% and 6% of the interventions. Outcomes included comprehensive medication review (46.7%), improved adherence (6.5%), therapeutic success (6.5%), improved administration technique (5.0%), and initiation of new therapy (5.0%). Conclusion: Through the provision of MTM, pharmacists were able to identify and intervene with medication-related problems. These interventions are instrumental in helping patients better manage their asthma/COPD. The high resolution rate was encouraging. Larger scale studies are needed to assess clinical and economic outcomes.

Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic

“… 39 Healthcare providers including pharmacists may identify rescue inhaler overuse and resolve MRPs, while monitoring patients with ACO. 40 Our study also showed that the oral corticosteroid fill claims decreased during the first few months of 2020, which may have been a result of preventive measures such as the facemask use and social distancing policies. 41 …”

Knowledge, Attitude, and Perception of Health Care Providers Providing Medication Therapy Management (MTM) Services to Older Adults in Saudi Arabia

“…adverse drug reactions (ADRs) identified through MTM consultations pertain to medication appropriateness, efficacy, safety, and adherence [4]. To provide additional insight, a study carried out in 2021 uncovered 192 Medication-related Problems (MDRs) during MTM interventions for a sample of 384 individuals with type 2 diabetes, hypertension, and similar coexisting health conditions [5]. Notably, this study observed a notable increase in health promotion, particularly within the diabetic subgroup [5].…”

“…To provide additional insight, a study carried out in 2021 uncovered 192 Medication-related Problems (MDRs) during MTM interventions for a sample of 384 individuals with type 2 diabetes, hypertension, and similar coexisting health conditions [5]. Notably, this study observed a notable increase in health promotion, particularly within the diabetic subgroup [5]. An additional study, which highlighted the beneficial impacts of MTM services, examined 63 patients dealing with asthma and chronic obstructive pulmonary disease, with the majority of cases involving complex medication regimens (53.2%).…”