Medication therapy management programs: Promises and pitfalls

Journal of Managed Care Pharmacy

Volumn 20, Issue 12, 2014, Pages 1162-1182

  Ai, Amy L ^a   Carretta, Henry ^a   Beitsch, Leslie M ^a   Watson, Leah ^b   Munn, Jean ^a   Mehriary, Sarah ^a  

^a FLORIDA STATE UNIVERSITY   (United States)

^b Wisconsin Department of Children and Families   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST CONTROL; DRUG COST; DRUG SAFETY; HEALTH CARE COST; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HUMAN; MEDICAID; MEDICARE; MEDICATION THERAPY MANAGEMENT; OUTCOME ASSESSMENT; PATIENT COMPLIANCE; PRESCRIPTION; QUALITY OF LIFE; ECONOMIC ASPECT; MEDICATION COMPLIANCE; PROGRAM EFFECTIVENESS; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; EVIDENCE BASED MEDICINE; ORGANIZATION AND MANAGEMENT; UNITED STATES;

EVIDENCE-BASED MEDICINE; HUMANS; MEDICATION THERAPY MANAGEMENT; OUTCOME ASSESSMENT (HEALTH CARE); RANDOMIZED CONTROLLED TRIALS AS TOPIC; UNITED STATES;

EID: 84925354712     PISSN: 10834087     EISSN: None     Source Type: Journal    
DOI: 10.18553/jmcp.2014.20.12.1162     Document Type: Article

References (77)

1. Welch EK, Delate T, Chester EA, Stubbings T. Assessment of the impact of medication therapy management delivered to home-based Medicare beneficiaries. Ann Pharmacother. 2009;43(4):603-10.
2. Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Public Law 108-173. December 8, 2003. Available at: http://www.gpo.gov/fdsys/pkg/PLAW-108publ173/content-detail.html. Accessed October 18, 2014.
3. Pindolia VK, Stebelsky L, Romain TM, Luoma L, Nowak SN, Gillanders F. Mitigation of medication mishaps via medication therapy management. Ann Pharmacother. 2009;43(4):611-20.
4. Centers for Medicare & Medicaid Services. Medicare Part D medication therapy management (MTM) programs: 2009 fact sheet. Updated July 21, 2009. Available at: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/MTMFactSheet_2009_06-2009_fnl.pdf. Accessed October 18, 2014.
5. Smith SR, Clancy CM. Medication therapy management programs: forming a new cornerstone for quality and safety in Medicare. Am J Med Qual. 2006;21(4):276-79.
6. Lau DT, Briesacher BA, Touchette DR, Stubbings J, Ng JH. Medicare Part D and quality of prescription medication use in older adults. Drugs Aging. 2011;28(10):797-807.
7. Patient Protection and Affordable Care Act. Public Law 111-148. March 23, 2010. Available at: http://www.gpo.gov/fdsys/granule/PLAW-111publ148/PLAW-111publ148/content-detail.html. Accessed October 18, 2014.
8. Matzke GR, Ross LA. Health-care reform 2010: how will it impact you and your practice?. Ann Pharmacother. 2010;44(9):1485-91.
9. Health Care and Education Reconciliation Act of 2010. Public Law 111-152. March 30, 2010. Available at: http://www.gpo.gov/fdsys/pkg/PLAW-111publ152/content-detail.html. Accessed October 18, 2014.
10. American Pharmacists Association and National Association of Chain Drug Stores Foundation. Medication therapy management in pharmacy practice: core elements of an MTM service model. Version 2.0. March 2008. Available at: http://www.pharmacist.com/sites/default/files/files/core_elements_of_an_mtm_practice.pdf. Accessed October 18, 2014.
11. Pellegrino AN, Martin MT, Tilton JJ, Touchette DR. Medication therapy management services: definitions and outcomes. Drugs. 2009;69(4):393-406.
12. Spooner JJ. Medication therapy management programs: when will the outcomes come out?. J Manag Care Pharm. 2007;13(3):276-77. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=7545.
13. Holtorf AP, McAdam-Marx C, Schaaf D, Eng B, Oderda G. Systematic review on quality control for drug management programs: is quality reported in the literature?. BMC Health Serv Res. 2009;9:38.
14. McAdam-Marx C, Schaaf DT, Holtorf AP, Eng B, Oderda GM. Systematic analysis of outcomes evaluations applied to drug management programs. Am J Manag Care. 2008;14(11 Suppl):SP36-45.
15. Christensen D, Trygstad T, Sullivan R, Garmise J, Wegner SE. A pharmacy management intervention for optimizing drug therapy for nursing home patients. Am J Geriatr Pharmacother. 2004;2(4):248-56.
16. Michaels NM, Jenkins GF, Pruss DL, Heidrick JE, Ferreri SP. Retrospective analysis of community pharmacists' recommendations in the North Carolina Medicaid medication therapy management program. J Am Pharm Assoc (2003). 2010;50(3):347-53.
17. Reinke T. Medication therapy management program in N.C. saves $13 million. Manag Care. 2011;20(10):17-18.
18. Ramalho de Oliveira D, Brummel AR, Miller DB. Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm. 2010;16(3):185-95. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=8313.
19. Isetts BJ, Schondelmeyer SW, Artz MB, et al. Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J Am Pharm Assoc (2003). 2008;48(2):203-11.
20. Hirsch JD, Gonzales M, Rosenquist A, Miller TA, Gilmer TP, Best BM. Antiretroviral therapy adherence, medication use, and health care costs during 3 years of a community pharmacy medication therapy management program for Medi-Cal beneficiaries with HIV/AIDS. J Manag Care Pharm. 2011;17(3):213-23. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=8973.
21. Hirsch JD, Rosenquist A, Best BM, Miller TA, Gilmer TP. Evaluation of the first year of a pilot program in community pharmacy: HIV/AIDS medication therapy management for Medi-Cal beneficiaries. J Manag Care Pharm. 2009;15(1):32-41. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=8066.
22. Bunting BA, Smith BH, Sutherland SE. The Asheville Project: clinical and economic outcomes of a community-based long-term medication therapy management program for hypertension and dyslipidemia. J Am Pharm Assoc (2003). 2008;48(1):23-31.
23. Wittayanukorn S, Westrick SC, Hansen RA, et al. Evaluation of medication therapy management services for patients with cardiovascular disease in a self-insured employer health plan. J Manag Care Pharm. 2013;19(5):385-95. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=16595.
24. Moore JM, Shartle D, Faudskar L, Matlin OS, Brennan TA. Impact of a patient-centered pharmacy program and intervention in a high-risk group. J Manag Care Pharm. 2013;19(3):228-36. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=16313.314.
25. Hui RL, Yamada BD, Spence MM, Jeong EW, Chan J. Impact of a Medicare MTM program: evaluating clinical and economic outcomes. Am J Manag Care. 2014;20(2):e43-51.
26. Murray MD, Ritchey ME, Wu J, Tu W. Effect of a pharmacist on adverse drug events and medication errors in outpatients with cardiovascular disease. Arch Intern Med. 2009;169(8):757-63.
27. Borges AP, Guidoni CM, Freitas O, Pereira LR. Economic evaluation of outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service. Arq Bras Endocrinol Metabol. 2011;55(9):686-91.
28. Chrischilles EA, Carter BL, Lund BC, et al. Evaluation of the Iowa Medicaid pharmaceutical case management program. J Am Pharm Assoc (2003). 2004;44(3):337-49.
29. Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA. 2007;298(1):61-69.
30. Fitzgerald LS, Hanlon JT, Shelton PS, et al. Reliability of a modified medication appropriateness index in ambulatory older persons. Ann Pharmacother. 1997;31(5):543-48.
31. Duke University Center for the Study on Aging. Multidimensional Functional Assessment: the OARS Methodology. Durham, NC: Duke University Press; 1978.
32. Schulz RM, Porter C, Lane M, Cornman C, Branham L. Impact of a medication management system on nursing home admission rate in a community-dwelling nursing home-eligible Medicaid population. Am J Geriatr Pharmacother. 2011;9(1):69-79.
33. Clark DO, Von Korff M, Saunders K, Baluch WM, Simon GE. A chronic disease score with empirically derived weights. Med Care. 1995;33(8):783-95.
34. Walker PC, Bernstein SJ, Jones JN, et al. Impact of a pharmacist-facilitated hospital discharge program: a quasi-experimental study. Arch Intern Med. 2009;169(21):2003-10.
35. Sarangarm P, London MS, Snowden SS, et al. Impact of pharmacist discharge medication therapy counseling and disease state education: Pharmacist Assisting at Routine Medical Discharge (project PhARMD). Am J Med Qual. 2013;28(4):292-300.
36. Al-Rashed SA, Wright DJ, Roebuck N, Sunter W, Chrystyn H. The value of inpatient pharmaceutical counselling to elderly patients prior to discharge. Br J Clin Pharmacol. 2002;54(6):657-64.
37. Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009;150(3):178-87.
38. Koehler BE, Richter KM, Youngblood L, et al. Reduction of 30-day postdischarge hospital readmission or emergency department (ED) visit rates in high-risk elderly medical patients through delivery of a targeted care bundle. J Hosp Med. 2009;4(4):211-18.
39. Nazareth I, Burton A, Shulman S, Smith P, Haines A, Timberal H. A pharmacy discharge plan for hospitalized elderly patients-a randomized controlled trial. Age Ageing. 2001;30(1):33-40.
40. Nietert PJ, Tilley BC, Zhao W, et al. Two pharmacy interventions to improve refill persistence for chronic disease medications: a randomized, controlled trial. Med Care. 2009;47(1):32-40.
41. Stowasser DC, Stowasser M, Collins DM. A randomised controlled trial of medication liaison services: patient outcomes. J Pharm Pract Res. 2002;32(2):133-40.
42. Schnipper JL, Kirwin JL, Cotugno MC, et al. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006;166(5):565-71.
43. Doucette WR, Witry MJ, Farris KB, McDonough RP. Community pharmacist-provided extended diabetes care. Ann Pharmacother. 2009;43(5):882-89.
44. Planas LG, Crosby KM, Mitchell KD, Farmer KC. Evaluation of a hypertension medication therapy management program in patients with diabetes. J Am Pharm Assoc (2003). 2009;49(2):164-70.
45. Wubben DP, Vivian EM. Effects of pharmacist outpatient interventions on adults with diabetes mellitus: a systematic review. Pharmacotherapy. 2008;28(4):421-36.
46. Carter BL, Ardery G, Dawson JD, et al. Physician and pharmacist collaboration to improve blood pressure control. Arch Intern Med. 2009;169(21):1996-2002.
47. Isetts BJ, Brown LM, Schondelmeyer SW, Lenarz LA. Quality assessment of a collaborative approach for decreasing drug-related morbidity and achieving therapeutic goals. Arch Intern Med. 2003;163(15):1813-20.
48. Isetts BJ, Schondelmeyer SW, Heaton AH, Wadd WB, Hardie NA, Artz MB. Effects of collaborative drug therapy management on patients' perceptions of care and health-related quality of life. Res Social Adm Pharm. 2006;2(1):129-42.
49. Moczygemba LR, Barner JC, Brown CM, et al. Patient satisfaction with a pharmacist-provided telephone medication therapy management program. Res Social Adm Pharm. 2010;6(2):143-54.
50. Wilk JE, West JC, Rae DS, Rubio-Stipec M, Chen JJ, Regier DA. Medicare Part D prescription drug benefits and administrative burden in the care of dually eligible psychiatric patients. Psychiatr Serv. 2008;59(1):34-39.
51. West JC, Wilk JE, Rae DS, et al. Medicaid prescription drug policies and medication access and continuity: findings from ten states. Psychiatr Serv. 2009;60(5):601-10.
52. St Peter WL. Chronic kidney disease and Medicare. J Manag Care Pharm. 2007;13(9 Suppl D):S2-5. Available at: http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=13951.
53. Abdelgawad T, Egbuonu-Davis L. Preferred drug lists and Medicaid prescriptions. Pharmacoeconomics. 2006;24(Suppl 3):55-63.
54. Ridley DB, Axelsen KJ. Impact of Medicaid preferred drug lists on therapeutic adherence. Pharmacoeconomics. 2006;24(Suppl 3):65-78.
55. Cunningham PJ. Prescription drug access: not just a Medicare problem. Issue Brief Cent Stud Health Syst Change. 2002;(51):1-4.
56. Wang J, Mullins CD, Brown LM, et al. Disparity implications of Medicare eligibility criteria for medication therapy management services. Health Serv Res. 2010;45(4):1061-82.
57. Wang J, Brown LM, Hong SH. Racial and ethnic disparities in meeting Part D MTM eligibility criteria among the non-Medicare population. J Am Pharm Assoc (2003). 2012;52(5):e87-96.
58. Munshi KD, Shih YC, Brown LM, Dagogo-Jack S, Wan JY, Wang J. Disparity implications of the Medicare medication therapy management eligibility criteria: a literature review. Expert Rev Pharmacoecon Outcomes Res. 2013;13(2):201-16.
59. Moczygemba LR, Barner JC, Gabrillo ER, Godley PJ. Development and implementation of a telephone medication therapy management program for Medicare beneficiaries. American journal of health-system pharmacy. Am J Health Syst Pharm. 2008;65(17):1655-60.
60. Schommer JC, Planas LG, Johnson KA, Doucette WR. Pharmacistprovided medication therapy management (part 2): payer perspectives in 2007. J Am Pharm Assoc (2003). 2008;48(4):478-86.
61. Academy of Managed Care Pharmacy. Sound medication therapy management programs, version 2.0 with validation study. J Manag Care Pharm. 2008;14(1 Suppl B):S2-44. Available at: http://www.amcp.org/data/jmcp/JMCPSuppB_Jan08.pdf.
62. Christensen DB, Roth M, Trygstad T, Byrd J. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan. J Am Pharm Assoc (2003). 2007;47(4):471-83.
63. Doucette WR, McDonough RP, Klepser D, McCarthy R. Comprehensive medication therapy management: identifying and resolving drug-related issues in a community pharmacy. Clin Ther. 2005;27(7):1104-11.
64. Herbert KE, Urmie JM, Newland BA, Farris KB. Prediction of pharmacist intention to provide Medicare medication therapy management services using the theory of planned behavior. Res Social Adm Pharm. 2006;2(3):299-314.
65. Boyd ST, Boyd LC, Zillich AJ. Medication therapy management survey of the prescription drug plans. J Am Pharm Assoc (2003). 2006;46(6):692-99.
66. Touchette DR, Burns AL, Bough MA, Blackburn JC. Survey of medication therapy management programs under medicare part D. J Am Pharm Assoc (2003). 2006;46(6):683-91.
67. Pharmacy Quality Alliance. Web site. Available at: http://www.pqaalliance.org/. Accessed October 18, 2014.
68. Nau D. PQA Executive update on medication therapy measures in Medicare Part D plan ratings 2012. Pharmacy Quality Alliance (PQA), Inc. Springfield, VA 2012.
69. Shoemaker SJ, Hassol A. Understanding the landscape of MTM programs for Medicare Part D: Results from a study for the Centers for Medicare & Medicaid Services. J Am Pharm Assoc (2003). 2011;51(4):520-26.
70. Bodenheimer T, Berry-Millet R. Care management of patients with complex health care needs. Research Synthesis Report No. 19. Robert Wood Johnson Foundation. December 2009. Available at: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2009/rwjf49853/subassets/rwjf49853_1. Accessed October 18, 2014.
71. Wilson T, MacDowell M, Salber P, Montrose G, Hamm C. Evaluation methods in disease management studies 2004-07. Dis Manag Health Out. 2008;16(5):365-73.
72. Congressional Budget Office. An analysis of the literature on disease management programs. October 13, 2004. Available at: http://www.cbo.gov/sites/default/files/10-13-diseasemngmnt.pdf. Accessed October 18, 2014.
73. Bernstein J, Chollet D, Peterson GG. Disease management: does it work? Mathematica Policy Research, Inc. Issue Brief. No. 4, May 2010. Available at: http://www.mathematica-mpr.com/~/media/publications/PDFs/health/reformhealthcare_IB4.pdf. Accessed October 18, 2014.
74. Care Continuum Alliance. Outcomes guidelines report. Volume 5. Washington, DC: Care Continuum Alliance; 2010.
75. National Committee for Quality Assurance. New NCQA disease management standards focus on measurement, quality improvement and transparency. News Release. December 11, 2009. Available at: http://www.ncqa.org/Newsroom/2010NewsArchives/NCQANewsReleaseDecember112009.aspx. Accessed October 18, 2014.
76. Mattke S, Seid M, Ma S. Evidence for the effect of disease management: is $1 billion a year a good investment?. Am J Manag Care. 2007;13(12):670-76.
77. Freeman R, Lybecker KM, Taylor WT. The effectiveness of disease management programs in the Medicaid population. Hamilton, ON: The Cameron Institute; 2011.