Development and initial assessment of the medication user self-evaluation (MUSE) tool

Area of Science:

• Health Services Research
• Pharmaceutical Services
• Geriatric Pharmacy

Background:

• Medicare beneficiaries often require medication therapy management (MTM) services.
• Identifying suitable candidates for MTM using claims data alone can be challenging.
• Patient-reported data offers a valuable supplement for identifying beneficiaries who would benefit from MTM.

Purpose of the Study:

• To develop and evaluate a patient self-assessment tool, the Medication User Self-Evaluation (MUSE) tool.
• To identify Medicare Part D beneficiaries who would benefit from a comprehensive medication review.
• To assess the initial performance of the MUSE tool in targeting MTM services.

Main Methods:

• A survey of 225 Medicare beneficiaries collected demographic, adherence, and symptom data.
• Clinical pharmacists judged the likelihood of benefit from MTM for each patient profile.
• Ordinal logistic regression models were used to predict MTM benefit likelihood based on MUSE items.
• Model selection prioritized predictive accuracy and agreement with expert judgment.

Main Results:

• The final MUSE tool includes seven items: number of medications, physicians, pharmacies, recent hospitalizations, medication forgetfulness, cost concerns, and medical conditions.
• These items were identified through analysis of patient medication profiles and expert review.
• The tool demonstrated potential for targeting MTM services.

Conclusions:

• The 7-item MUSE tool is effective in identifying Medicare beneficiaries who would benefit from MTM services.
• Comprehensive medication reviews can be more effectively targeted using the MUSE tool.
• This patient-reported tool enhances the identification process for MTM services.