TY - JOUR
T1 - Clinical and economic outcomes of medication therapy management services
T2 - The Minnesota experience
AU - Isetts, Brian J.
AU - Schondelmeyer, Stephen W.
AU - Artz, Margaret B.
AU - Lenarz, Lois A.
AU - Heaton, Alan H.
AU - Wadd, Wallace B.
AU - Brown, Lawrence M.
AU - Cipolle, Robert J.
PY - 2008
Y1 - 2008
N2 - Objectives: To (1) provide medication therapy management (MTM) services to patients, (2) measure the clinical effects associated with the provision of MTM services, (3) measure the percent of patients achieving Healthcare Effectiveness Data and Information Set (HEDIS) goals for hypertension and hyperlipidemia in the MTM services intervention group in relationship to a comparison group who did not receive MTM services, and (4) compare patients' total health expenditures for the year before and after receiving MTM services. Design: Prospective study. Setting: Six ambulatory clinics in Minnesota from August 1, 2001, to July 31, 2002. Patients: 285 intervention group patients with at least 1 of 12 medical conditions using prestudy health claims; 126 comparison group patients with hypertension and 126 patients with hyperlipidemia were selected among 9 clinics without MTM services for HEDIS analysis. Intervention: MTM services provided by pharmacists to BlueCross BlueShield health plan beneficiaries in collaboration with primary care providers. Main outcome measures: Drug therapy problems resolved; percentage of patients' goals of therapy achieved and meeting HEDIS measures for hypertension and hypercholesterolemia. Total health expenditures per person were measured for a 1-year period before and after enrolling patients in MTM services. Results: 637 drug therapy problems were resolved among 285 intervention patients, and the percentage of patients' goals of therapy achieved increased from 76% to 90%. HEDIS measures improved in the intervention group compared with the comparison group for hypertension (71% versus 59%) and cholesterol management (52% versus 30%). Total health expenditures decreased from $11,965 to $8,197 per person (n = 186, P < 0.0001). The reduction in total annual health expenditures exceeded the cost of providing MTM services by more than 12 to 1. Conclusion: Patients receiving face-to-face MTM services provided by pharmacists in collaboration with prescribers experienced improved clinical outcomes and lower total health expenditures. Clinical outcomes of MTM services have chronic care improvement and value-based purchasing implications, and economic outcomes support inclusion of MTM services in health plan design.
AB - Objectives: To (1) provide medication therapy management (MTM) services to patients, (2) measure the clinical effects associated with the provision of MTM services, (3) measure the percent of patients achieving Healthcare Effectiveness Data and Information Set (HEDIS) goals for hypertension and hyperlipidemia in the MTM services intervention group in relationship to a comparison group who did not receive MTM services, and (4) compare patients' total health expenditures for the year before and after receiving MTM services. Design: Prospective study. Setting: Six ambulatory clinics in Minnesota from August 1, 2001, to July 31, 2002. Patients: 285 intervention group patients with at least 1 of 12 medical conditions using prestudy health claims; 126 comparison group patients with hypertension and 126 patients with hyperlipidemia were selected among 9 clinics without MTM services for HEDIS analysis. Intervention: MTM services provided by pharmacists to BlueCross BlueShield health plan beneficiaries in collaboration with primary care providers. Main outcome measures: Drug therapy problems resolved; percentage of patients' goals of therapy achieved and meeting HEDIS measures for hypertension and hypercholesterolemia. Total health expenditures per person were measured for a 1-year period before and after enrolling patients in MTM services. Results: 637 drug therapy problems were resolved among 285 intervention patients, and the percentage of patients' goals of therapy achieved increased from 76% to 90%. HEDIS measures improved in the intervention group compared with the comparison group for hypertension (71% versus 59%) and cholesterol management (52% versus 30%). Total health expenditures decreased from $11,965 to $8,197 per person (n = 186, P < 0.0001). The reduction in total annual health expenditures exceeded the cost of providing MTM services by more than 12 to 1. Conclusion: Patients receiving face-to-face MTM services provided by pharmacists in collaboration with prescribers experienced improved clinical outcomes and lower total health expenditures. Clinical outcomes of MTM services have chronic care improvement and value-based purchasing implications, and economic outcomes support inclusion of MTM services in health plan design.
KW - Chronic disease
KW - Collaborative practice
KW - Economics
KW - Medication therapy management services
KW - Pharmaceutical care
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U2 - 10.1331/JAPhA.2008.07108
DO - 10.1331/JAPhA.2008.07108
M3 - Article
C2 - 18359733
AN - SCOPUS:42149166879
SN - 1544-3191
VL - 48
SP - 203
EP - 214
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 2
ER -