Review of Studies in Medication Therapy Management

Various studies have been conducted to evaluate different dimensions of the medication therapy management. Some of the important studies have been discussed here.

Hansen et al. conducted a study in North Carolina in January 2005 to evaluate the types of cognitive services offered and the number of patients served by pharmacies under MTM. They also tried to evaluate whether the current and expected practices would meet the potential needs of enrollees. It was a cross-sectional study, and they surveyed 1,593 community pharmacy managers. They tried to gather information regarding types and frequency of services offered by pharmacies, along with details of payment for the services. They mostly contacted pharmacy managers through e-mails or paper mails. The obtained data was analyzed using descriptive statistics and bivariate analyses.

The results indicated that the percentage of community pharmacies providing cognitive services increased slightly from a 1999 survey. Moreover, it was observed that pharmacists with a bachelor’s degree were more likely to offer services than those with a doctor of pharmacy degree. As a whole, 31 percent respondents provided MTM services at par with the professionwide consensus definition.

Another study was conducted in North Carolina by Christensen et al. to identify the feasibility of a pharmacist-based MTM service for North Carolina State Health Plan enrollees (471). The objectives were to describe identification, resolution and results obtained after changes in drug therapy in relation to potential drug therapy problems (PDTPs); measure changes in the cost of drug therapy with MTM services; and measure the level of patient satisfaction.

The participants included 67 patients, who used a large amount of prescription drugs, 10 community/ambulatory pharmacists, and approximately 600 participants from two control groups. It was a before/after design with two control groups, using propensity scoring to identify comparison groups. Also, MTM reviews were conducted for participating patients by pharmacists.

Coming to the results, the pharmacists identified an average of 3.6 PDTPs per patient initially, and nearly 50 percent patients with PDTPs had a change in drug therapy (Christensen et al. 476). Pharmacists offered education regarding medication use, disease management, adherence and self-cure. Though there was a noticeable improvement in patient satisfaction and decrease in prescription use, no significant changes were found in patient co-payment or insurer prescription costs.

In another study, Horning et al. tried to compare the adherence to clinical practice guidelines (CPGs) in patients in long-term-care facilities who received pharmacist consultation on disease state management (DSM) with patients in LTCFs who received normal drug regimen review (DRR) (28-35). They compared 107 patients who received DSM service with 304 patients who received DRR services.

The results showed that patients with DSM service had better adherence to CPGs against their counterparts. The results confirmed that the CPG adherence for common chronic disease states was higher in patients who had DSM service by pharmacists.

Stebbins et al. conducted a study based on PRICE clinic model, designed to increase cost effectiveness (333-40). It was said that the model was adaptable to medication therapy management program (MTMP) services in order to aid low-income elderly patients to reduce drug expenses, provide patients with efficient and cost-effective drug regimens and improve access to necessary medications.

The study was done by documenting and analyzing data from 520 patients who were present in the PRICE clinic in 2002. They analyzed the number and type of pharmacist interventions, and changes in generic drug use and out-of-pocket costs. The results indicated that timely intervention by pharmacists led to improvements in appropriate drug use, reduction of OOP costs and access to needed drugs.

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