ABSTRACT

Purpose: Drug therapy problems impact about one-third of US adults, and these issues are likely to continue to worsen as the population of aging Americans increases. The objective of this study is to assess the feasibility of a remotely delivered Comprehensive Medication Management (CMM) for primary practice patients who are polypharmatic and at high risk for drug therapy problems.

Methods: Using medical and prescription claims data, a list of Medicare Advantage beneficiaries at high risk for drug therapy problems was identified. Participants were enrolled in a 6-month CMM program from February – November 2020. In the program, their existing drug therapy was assessed by a pharmacist, Drug therapy problems were identified and resolved. A Collaborative Practice Agreement allowed the pharmacists to make prescription changes as needed.

Results: Eighty-three percent (202) of contacted individuals agreed to participate in the study. All participants were on five medications or more, and 71% were on more than eight. A clinical pharmacist found that 86% of participants had a drug therapy problem according to classification criteria. Seventy-nine percent of all drug therapy problems identified were resolved upon completion of the study.

Conclusion: The findings of this study suggest that engagement of a remote clinical pharmacist can contribute to efficient resolution of most drug therapy problems identified in a primary care population. A service model using remote pharmacist services may be an effective means of improving team-based primary care medication management for this population.

摘要

目的：药物治疗问题影响了大约三分之一的美国成年人，随着美国老龄化人口的增加，这些问题可能会继续恶化。本研究的目的是评估远程提供综合药物管理 (CMM) 的可行性，适用于多药治疗和药物治疗问题高风险的初级实践患者。

方法：使用医疗和处方索赔数据，确定了面临药物治疗问题高风险的 Medicare Advantage 受益人名单。参与者于 2020 年 2 月至 11 月参加了为期 6 个月的 CMM 计划。在该计划中，他们现有的药物治疗由药剂师评估，确定并解决药物治疗问题。合作实践协议允许药剂师根据需要更改处方。

结果：百分之八十三 (202) 的联系人员同意参与该研究。所有参与者都服用了五种或更多的药物，71% 的人服用了超过 8 种。一位临床药剂师发现，根据分类标准，86% 的参与者存在药物治疗问题。研究完成后，确定的所有药物治疗问题中有 79% 得到解决。

结论：这项研究的结果表明，远程临床药剂师的参与有助于有效解决初级保健人群中发现的大多数药物治疗问题。使用远程药剂师服务的服务模式可能是改善该人群基于团队的初级保健药物管理的有效手段。