Pharmacist-led medication management program within a patient-centered medical home

Area of Science:

• Health Services Research
• Pharmacoeconomics
• Primary Care Medicine

Background:

• Patient-centered medical homes (PCMH) aim to improve care coordination and patient outcomes.
• Medication management programs (MMP) led by clinical pharmacists are increasingly integrated into primary care settings.
• Evaluating the impact of pharmacist-led MMPs on healthcare resource utilization is crucial for understanding their value.

Purpose of the Study:

• To evaluate the impact of a clinical pharmacist-led medication management program (MMP) within a patient-centered medical home (PCMH) on healthcare resource utilization.
• To compare healthcare resource use among patients in an MMP within a PCMH, patients in a PCMH without the MMP, and patients receiving usual care in non-PCMH clinics.

Main Methods:

• Retrospective analysis of electronic health records from Sutter Health.
• Inclusion of three patient cohorts: MMP within PCMH, PCMH without MMP, and usual care in non-PCMH clinics.
• Matching patients on propensity for medication management and primary outcome measure of healthcare resource use (ambulatory visits, ED visits, hospitalizations).

Main Results:

• MMP patients had more ambulatory care visits than PCMH patients (p=0.004) but fewer hospitalizations (p=0.003).
• MMP patients had fewer hospitalizations (p<0.001) and ED visits (p=0.014) compared to usual care patients.
• No significant differences in healthcare resource use were found between PCMH and usual care cohorts.

Conclusions:

• Pharmacist-led MMPs in PCMH settings are associated with increased ambulatory care visits but decreased hospitalizations.
• MMP patients demonstrated reduced hospitalizations and ED visits compared to patients receiving usual care.
• The study suggests that pharmacist-led medication management can optimize healthcare resource utilization within primary care settings.