Clinicians tend to prevent and control disease through the use of medication approximately 80 percent of the time. A pharmacist can contribute high value and quality in a collaborative health care practice by managing medication use. This is a process which begins with patients and seeks to optimize their medications by identifying and resolving drug therapy problems that are preventing them from reaching the goals of better health, better care, and lower costs.
A new line of medical service called comprehensive medication management (CMM) embeds a pharmacist directly into the workflow at the primary care clinic. The pharmacist, along with the care team (provider, behaviorist and care coordinator) aim to maximize the patients’ medication regimen by deprescribing when appropriate, reducing potential adverse effects, improving adherence, increasing patient knowledge , recommending less expensive equi-potent drugs, and offering point of care medication consults.
Initially, patients on five or more medications will be pre-screened and invited to participate in the CMM program. Eventually, all patients will be included, and comprehensive medication management will be fully incorporated into all local primary care clinics.
Patients on five or medications are identified prior to their office visit. During the visit, they are invited to participate in an effort to reduce their number of medications through a pharmacist review. If a patient agrees, they meet the pharmacist briefly in a warm hand-off and then schedule an office visit with the pharmacist during which medications are reviewed and recommendations are made. An assessment including side effects, patient quality of life, alternative treatments, cost, ease of compliance with the regimen, and suitability for the diagnosis is made during the visit. The pharmacist makes recommendations to the provider and follows up with the patient.
We monitor patients’ quality of life scores, patient and provider satisfaction with the program, and medication costs along with diagnosis-related parameters, including A1C, blood pressure, and PHQ-9 scores. ED visits are tracked pre- and post- implementation. To assess effectiveness of the program, these measures are compared to a clinic within the same system that does not have a CMM program pharmacist on site.
This idea has the potential to impact issues such as antibiotic overuse, the opioid epidemic, rising health costs, and medication-related morbidity and mortality.
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