The Kaiser Permanente/USC Patient Consultation Study: Change in use and cost of health care services

McCombs, Jeffrey S.; Liu, Gordon; Shi, Jinhai; Feng, Weiwei; Cody, Marisue; Parker, Joseph P.; Nichol, Michael B.; Hay, Joel W.; Johnson, Kathleen A.; Groshen, Susan; Nye, Matthew T.

doi:10.1093/ajhp/55.23.2485

Cited by 29 publications

(20 citation statements)

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“…4 It can be expected that well-balanced MTM programs will provide the best outcomes, with providers using the most appropriate means to reach and educate patients. [7][8][9][10][11][12] Having data to guide the right mix of services will be valuable since models will likely include a combination of face-to-face encounters and long-term telephone or paper communication as patientmonitoring mechanisms.…”

Section: Phase Model and Building-block Integrationmentioning

confidence: 99%

“…Numerous studies provide evidence that integration of clinical pharmacist services in patient care positively affects therapeutic, safety, quality of life, and economic outcomes. [7][8][9][10][11][12] However, the Centers for Medicare and Medicaid Services (CMS) requirements for participation by prescription drug plans (PDPs) in MTM services are very flexible and do not specify by whom and how MTM services are provided, making it necessary to develop reliable quality measures to ensure patients' needs are being met. 4 How the quality of MTM programs will be measured and reported by the multitude of PDPs is undetermined.…”

mentioning

confidence: 99%

“…Further, these clinics and primary-care settings can serve as models for implementation in a variety of MTM delivery settings. 8,9,15,[18][19][20] The model proposed in this report is based on the many years of experience that health-system pharmacists have in the provision of MTM in outpatient clinics and other primarycare settings, before the implementation of Medicare Part D. [7][8][9][10][11][12] This model incorporates the necessary components for establishing broader quality measures for MTM, although the current opportunity is clearly with the Part D benefit, which does not include methods to assess clinical outcomes in its current design. 18 ASHP prepared this proposed framework for assuring quality MTM programs, since the perspectives and experience of health-system pharmacists will be valuable in shaping quality MTM programs.…”

mentioning

confidence: 99%

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Proposed model for assuring quality of Medicare’s medication therapy management

Chen

Thompson

2006

American Journal of Health-System Pharmacy

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Section: Phase Model and Building-block Integrationmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Proposed model for assuring quality of Medicare’s medication therapy management

Chen

Thompson

2006

American Journal of Health-System Pharmacy

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“…81 Economic benefits documented in the literature include a decreased number of medications 73 and decreased cost of health care use including decreased office visits, laboratory testing, and hospitalizations. 81,117 SUMMARY Medication noncompliance is a significant health problem resulting in poor patient outcomes and increased health care use. There are many words used to describe patient compliance including adherence and drug forgiveness.…”

Section: Outcome Measurementsmentioning

confidence: 99%

Comply With Us: Improving Medication Adherence

Tabor

Lopez

2004

Journal of Pharmacy Practice

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Medication noncompliance is a pervasive problem resulting in significant morbidity and mortality. There are many terms used to describe medication-taking behavior including compliance, adherence, intelligent compliance, and drug forgiveness. More recently, clinicians have focused on the need for a collaborative partnership with patients to attain medication adherence. Problems identified include the patient's failing to initiate therapy, underusing or overusing a drug, stopping a drug too soon, and mistiming or skipping doses. Adherence to medications is a complex health behavior. There are many risk factors associated with decreased compliance, and many strategies have been shown to improve drug-taking behavior and patient outcomes. By careful assessment, the pharmacist can identify the high-risk patient, recommend an individualized care plan, and provide the follow-up necessary to successfully change patient behavior. Pharmacists should focus on improving their own application of behavior modification principles and patient communication skills. Improved medication compliance results in improved humanistic, clinical, and economic outcomes.

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“…[12][13][14] Other studies using numerous study designs have shown that medication reviews, performed on a regular basis, help improve a variety of outcomes: reductions in blood glucose, hemoglobin A1C, total and low-density lipoprotein cholesterol, number of emergency department visits, hospital admissions, physician visits, and adverse drug reactions, as well as increases in patient satisfaction and self-reported health-related quality of life. [15][16][17][18][19][20][21][22][23][24][25][26][27] Increasing a patient's knowledge of his or her medications through medication reviews contributes to overall improved health outcomes. 10,21,23 The purpose of the current study is to assess the impact of medication reviews on patient understanding, compliance, drug-drug and drug-disease interactions, and adverse events.…”

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confidence: 99%

The Effect of Medication Reviews in a Rural Community Pharmacy Assistance Program: The Cenla Medication Access Program

Lefante

Harmon

Roy³

et al. 2005

Journal of Pharmacy Practice

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The purpose of this article is to determine the effect of medication reviews on patient understanding of and compliance to medications for participants in the Cenla Medication Access Program (CMAP). A sample of 844 individuals with a total of 2013 reviews over a period of 6 months to 1 year produced 5 outcome variables: the percentage of the total number of drugs the patient understands the purpose of (PURPOSE), understands the proper use of (USE), and is compliant with (COMPLIANCE) and the percentage of patients that experienced any drug-drug or drug-disease interactions (INTERACTION) or any adverse reactions (REACTION). Mixed-effects models and generalized estimating equations were used to assess change in PURPOSE, USE, COMPLIANCE, INTERACTION, and REACTION over time. All effects were adjusted for differences in age, race, gender, the number of years of education, total number of medications per patient, and the patient's primary diagnosis. Significant increases were observed for PURPOSE, USE, and COMPLIANCE. A significant decrease was observed for INTERACTION. No significant difference in REACTION was observed over time. CMAP has seen increases in patient understanding and compliance, as well as a decrease in drugdrug and drug-disease interactions through the first year of medication reviews.I NDIVIDUALS AGED 65 YEARS AND OLDER account for a little more than 12% of the US population, yet they consume nearly 25% to 35% of prescription medications. 1,2 Major problems facing the elderly population and all individuals on prescription medications are noncompliance with their medication regimens and adverse drug reactions. 3-5 As a group, the elderly population experiences more adverse drug reactions than any other age group. 1 On average, elderly persons in the United States are on 5 medications, and their risk for a drug-drug interaction can be as high as 50%. 2,6 As many as a quarter of all hospital admissions in elderly persons are drug related. 5 A way of increasing patient compliance and preventing adverse drug events and drug-drug interactions is through medication counseling from a licensed pharmacist. Research has shown that medication reviews and consultations can improve a variety of patient outcomes, including reducing adverse drug events. 7,8 Compliance with drug regimens is particularly important for elderly persons. A randomized trial of community pharmacists educating elderly patients taking 4

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The Kaiser Permanente/USC Patient Consultation Study: Change in use and cost of health care services

Cited by 29 publications

References 0 publications

Proposed model for assuring quality of Medicare’s medication therapy management

Proposed model for assuring quality of Medicare’s medication therapy management

Comply With Us: Improving Medication Adherence

The Effect of Medication Reviews in a Rural Community Pharmacy Assistance Program: The Cenla Medication Access Program

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