Meet The Newest Member Of Your Personal Healthcare Team
Pharmacists Revolutionize Patient Engagement Through Medication Therapy Management (MTM)
(Source: Forbes) As most patients in the American healthcare system know, it’s gotten harder and harder to maintain regular, detailed communication with your doctor. At least in terms of medication, pharmacists have begun to address this gap through regular, direct contact with their patients.
In Medication Therapy Management (MTM), a pharmacist evaluates a patient’s prescriptions and how the patient is feeling to identify and resolve issues including: untreated conditions, drug interactions, adverse drug reactions, inappropriate drugs or doses, and whether a patient is taking the medications as prescribed. The pharmacist is rapidly becoming the newest member of your personal healthcare team.
MTM has the potential to alleviate some glaring problems in America’s healthcare system. For example, about one-third of people over age 65 who take five or more medications experience some sort of adverse drug event, such as a bone-breaking fall, disorientation, inability to urinate, or heart failure.
Part of this problem is the cost of hospital readmissions, which is generally defined as a patient being hospitalized within 30 days of an initial hospital stay. If a hospital has a high proportion of patients readmitted within a short time frame, it may be an indication of inadequate quality of care in the hospital or a lack of appropriate coordination of post-discharge care.
The Centers for Medicare and Medicaid Services (CMS) estimate hospital readmissions cost the program $17.5 billion a year, at an average of $10,000 – $13,000 per patient readmitted. In many cases, readmissions are the result of adverse effects of medication therapies due to improper or non-adherence to medication regimens. Reflecting the importance of that last point, in October 2012, CMS began reducing Medicare payments for hospitals with excess readmissions (as compared to other hospitals with similar patient profiles). Because of this, there is a renewed focus on hospitals to continue to reduce their readmission rate.
To help address these issues, a new study evaluated the effectiveness of MTM on reducing hospital readmissions utilizing phone calls to patients from their pharmacist. Dr. Alan Zillich, study co-lead and Associate Professor of Pharmacy, Purdue University, explains the need driving this research. “Enhancing the quality of care for patients has always been the goal of healthcare providers, but the growing costs of Medicare and healthcare in general have put an even brighter spotlight on strategies to improve patient outcomes and reduce unnecessary costs.”
The study identified 232 out of 895 patients, or 26%, as “risk-level 1 patients” who are capable of basic functions, including the ability to dress themselves, answer the phone, etc. One of the key findings was that risk-level 1 patients in the MTM group experienced an 86% reduction in readmissions compared to the control group. To put it another way, the group receiving MTM was three times more likely to remain out of the hospital after 60 days. Patrick Dunham, study co-author and CEO of Curant Health, calls this “another powerful proof point for the value of MTM and its capability to simultaneously reduce costs and improve care across the healthcare continuum.”
When extrapolated to the entire Medicare population (minus expenses incurred to deliver MTM services) it’s reasonable to estimate net savings approaching $3 billion. By any measure, that’s a LOT of money. Dunham sums up the takeaway: “Medicare and other policy makers should consider cost-sharing and risk-based payment models for medication therapy management services, potentially through the newly created Accountable Care Organizations (ACOs) and the bundled payment demonstration projects. We know that MTM improves adherence, improves outcomes, and improves lives.”
It should also be noted that there are some legitimate concerns about MTM. Is having a pharmacist more directly involved in patient care equal or preferable to freeing up doctors’ time to better address the patient’s needs? Could sharing more information with pharmacists and, more importantly, pharmacies, raise additional privacy concerns?
In any case, a serious conversation about MTM is worth having. It addresses existing problems in our healthcare system with a new approach, and evidence is emerging that it works.