Pharmacist medication therapy management in home health care: Investigation of a sustainable practice model

Abstract

This pilot study demonstrated the positive economic impact of a pharmacist-run MTM program at VNS for patients with multiple chronic conditions and medication-related problems. Potential societal benefits include that community members admitted to VNS will continue to have access to a pharmacist as a standard of care with the continuation of this MTM program.

The Report of the 2020-2021 Professional Affairs Standing Committee: Pharmacists’ Unique Role and Integration in Healthcare Settings

“…Pharmacy Enhanced Services Network (CPESN). 21 Patient care services provided by pharmacists in non-primary care settings include acute care management (eg, rapid diagnostic tests), 18 comprehensive medication management, 6,16,18 disease state management, 6,10,18,22 drug cost management, 7,8 medication reconciliation, 7,8,13,15,18,20,23 medication therapy management, 7,8,9,14,17,18,20,24,25 pharmacist consultation services, 11,12 health care provider education, 7 patient-centered medical homes, 25 patient education, 7,8,13,18,23 population health services (eg, telehealth), 18 transitions of care services, 7,20 and wellness and prevention services (eg, clinical screenings, immunizations, risk assessment). 18 These services have been provided in many ways including in-person, electronically, and telephonically.…”

“…18 These services have been provided in many ways including in-person, electronically, and telephonically. Studies have indicated positive outcomes generated from patient care services provided by pharmacists in non-primary care settings including healthcare team satisfaction, 8,10 drug cost savings, 7,14,17,24 identification of medication discrepancies, 7 improvement in patient clinical outcomes, 9,14,20 improvement in patient medication adherence, 13,20 patient satisfaction, 17 reduction in hospital readmissions, 6,13 and that payers are open to reimbursing for clinical services provided by pharmacists in communitybased settings. 26 There are resources available to pharmacists with information to integrate and contribute to patient care in non-primary care settings, including appointment-based model resources, 27 billing and payment resources, 28 diversified revenue opportunities, 29 and pharmacist consulting services 30 These services and outcomes generated assist in demonstrating and justifying the pharmacist's role in team-based models of patient care.…”

“…2,3,4,5 The PAC conducted an environmental scan of the literature, resources, and tools pertaining to pharmacists being integrated in practice settings providing patient care in non-primary care settings. Information obtained documented the integration of pharmacist-provided patient care services in accountable care organizations affiliated with various health care settings, 6,7,8 ambulatory care specialty clinics, 9,10 home health care settings, 11,12,13,14 hospitals/healthsystems, 15,16,17 and community-based pharmacy settings, 18,19,20 including practices participating in the Community…”

Clinic- and Hospital-Based Home Care, Outpatient Parenteral Antimicrobial Therapy (OPAT) and the Evolving Clinical Responsibilities of the Pharmacist

“…Corsi et al reviewed the impact of a pharmacist medication review service in a visiting nurse service (VNS) in 2017 [ 63 ]. An average of 8.7 medication-related problems per patient were identified and reviewed by the pharmacist, including immunization requirement, improving adherence (inappropriate administration or technique or overuse), dose adjustment, adverse drug reaction, missing drug therapy, suboptimal drugs, cost-effective alternative, unnecessary treatment and drug interaction.…”

Community-based pharmacy residents: Transforming the health care landscape

“…Corsi and colleagues reported on the financial impact of a pharmacist-provided medication therapy management (MTM) program collaborating with a home health care agency and found that the average home health visit resulted in $1300 per comprehensive medication review. 10 Because their work showed the sustainability of pharmacist-provided services, a full-time position was created to expand the existing pharmacy program.…”