Best Practices: Improving Patient Outcomes and Costs in an ACO Through Comprehensive Medication Therapy Management.
Authors: Brummel A, Lustig A, Westrich K, Evans MA, Plank GS, Penso J, Dubois RW
Abstract
BACKGROUND: One of the most important and often overlooked challenges for accountable care organizations (ACOs) is ensuring the optimal use of pharmaceuticals, which can be accomplished by utilizing pharmacists' skillsets and leveraging their full clinical expertise. Developing capabilities that support, monitor, and ensure appropriate medication use, efficacy, and safety is critical to achieving optimal patient outcomes and, ultimately, to an ACO's success. The program described in this article highlights the best pr...
Source: Journal of Managed Care Pharmacy - December 12, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Medication therapy management programs: promises and pitfalls.
CONCLUSIONS: Evidence suggests that MTM services are a promising way to manage complex patients, but there are gaps in the literature largely because of the limited number of studies with strong designs. Stronger evaluation of MTM programs is warranted.
PMID: 25443511 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Sterile compounding: clinical, legal, and regulatory implications for patient safety.
CONCLUSIONS: Pharmacy compounding has the potential for significant safety risks. The purpose of the DQSA is to improve regulation of compounding pharmacies. Since registration as an outsourcing facility is voluntary, uncertainty still remains regarding advancement in safe compounding practices. MCOs can employ multiple strategies to ensure patient safety and promote appropriate drug therapy.
PMID: 25443512 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Evaluation of an integrated adherence program aimed to increase medicare part d star rating measures.
CONCLUSIONS: Members in this MA-PD plan dual-eligible population benefited from multiple points of contact to achieve increased adherence. Health plans can use network pharmacies, care management staff, and their pharmacy benefits managers to collaborate and implement interventions aimed to improve members' adherence to targeted maintenance medications and overall health plan quality performance and star ratings.
PMID: 25443513 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Geospatial analysis of statin adherence using pharmacy claims data in the state of michigan.
CONCLUSIONS: Significant variations in adherence exist across ZIP codes at a state level. Future research is needed to determine locally relevant factors associated with this finding, which may be used to derive locally meaningful interventions.
PMID: 25443514 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Magnitude of pharmacological nonadherence in hypertensive patients taking antihypertensive medication from a community pharmacy in Spain.
CONCLUSIONS: The magnitude of drug nonadherence varies depending on the method of measurement. The pill count method (reference method) revealed that 2 out of 3 patients with hypertension did not have good adherence. This study highlights the lack of antihypertensive drug adherence and the pharmacist's ability to detect the associated factors in order to find the best way to deal with nonadherence.
PMID: 25443515 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Impact of specialty pharmacy on telaprevir-containing 3-drug hepatitis C regimen persistence.
CONCLUSIONS: Patients who used a specialty pharmacy offering refill reminders, care management, and care coordination with prescribers were significantly more likely to be persistent to 3-drug hepatitis C regimens, compared with patients using a retail pharmacy.
PMID: 25443516 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Treatment patterns and annual drug costs of biologic therapies across indications from the humana commercial database.
CONCLUSIONS: The tumor necrosis factor blockers adalimumab, etanercept, and infliximab were the most commonly used biologics across indications. New patients were less persistent than those continuing on therapy. Among new patients, adalimumab had the lowest mean annual cost per treated patient, and etanercept had the lowest mean annual cost per treated patient among those continuing on therapy.
PMID: 25443517 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Impact of an Intravenous Trimethoprim/Sulfamethoxazole Shortage on Treatment Outcomes Among HIV-Infected Patients with Pneumocystis jirovecii Pneumonia.
CONCLUSIONS: The national shortage of IV TMP/SMX may have led to an immediate but temporary negative impact on treatment outcomes among HIV-infected patients with PJP at an academic medical center.Pharmacist collaboration with physicians may have helped mitigate the impact of this drug shortage on patient outcomes.
PMID: 25443518 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - December 6, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Measuring economic impact of applying daily average consumption limits.
CONCLUSION: Implementing DACON limits on selected medications provided a cost avoidance of approximately $720,000 over a 3-month period with limited interruption to patient access and relatively low administrative burden. This reduction could result in annualized savings of nearly $3 million.
PMID: 24456317 [PubMed - indexed for MEDLINE] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Discrepancies identified with the use of prescription claims and diagnostic billing data following a comprehensive medication review.
CONCLUSIONS: The study met its objective in determining the degree of discrepancies that existed when prescription claims data and ICD-9 billing data were used to identify MRPs and/or HRPs versus using patient-reported data. Data revealed that the presence of discrepancy is relatively large depending on the category, indicating a difficulty in accurately making recommendations with incomplete data or solely based on prescription claims and billing data. MTM services with patient interaction are vital in identifying information that allows for more appropriate decision making.
PMID: 24456318 [PubMed - indexed for ...
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Incremental health care resource utilization and economic burden of venous thromboembolism recurrence from a U.S. payer perspective.
CONCLUSIONS: VTE recurrence associated with a hospitalization or ER visit is associated with substantial health care resource utilization, which is primarily inpatient care undergone within the first 30 days following an initial VTE event. Thus, a sizeable portion of the economic burden of recurrent VTE is also incurred during this short period of time following an initial VTE event. Given that rates of VTE recurrence were high among patients identified as having received anticoagulant treatment, strategies to improve anticoagulation therapy among VTE patients in addition to other preventative measures are needed to lessen...
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Analysis of gastrointestinal prophylaxis in patients receiving dual antiplatelet therapy with aspirin and clopidogrel.
CONCLUSION: More than half of the patients did not receive GI prophylaxis appropriately. The most common reason for nonadherence to the consensus document was no prophylaxis when indicated. Vascular events could not be directly attributed to PPI use, and GI events occurred despite prophylaxis. Overall, there was a low incidence of adverse events related to the use of PPI therapy.
PMID: 24456320 [PubMed - indexed for MEDLINE] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
Adherence to national recommendations for safe methotrexate dispensing in community pharmacies.
CONCLUSIONS: Dutch community pharmacies seem to be adherent to most safe dispensing recommendations. However, inconsistencies exist between team members that emphasize the importance of addressing this issue and discussing recommendations within the team, as there is still room for improvement to ensure safe dispensing.
PMID: 24456321 [PubMed - indexed for MEDLINE] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
PCMHs, ACOs, and medication management: lessons learned from early research partnerships.
Authors: Schnur ES, Adams AJ, Klepser DG, Doucette WR, Scott DM
Abstract
The Patient Protection and Affordable Care Act has greatly accelerated the formation of team-based models of care delivery, primarily accountable care organizations (ACOs) and patient-centered medical homes (PCMHs). Many have written about the need to incorporate medication management services into these systems in order to improve care and reduce total health care costs. Two primary ways of doing so have emerged: (1) an embedded model, whereby pharmacists are employed directly by a physician practice, or (2) a "virtual care team"...
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research
