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Comprehensive Medication Management and Medication Adherence for Chronic Conditions
Amanda Brummel1, Angeline M Carlson2
11 Director, Clinical Ambulatory Pharmacy Services, Medication Therapy Management, Fairview Pharmacy Services, Minneapolis, Minnesota.
Journal of Managed Care & Specialty Pharmacy
|March 26, 2016
Summary
Face-to-face comprehensive medication management (CMM) services significantly improved medication adherence for patients with chronic diseases. This approach enhances patient outcomes and should be promoted by insurers and health plans.
Area of Science:
- Pharmacoeconomics and Health Services Research
- Chronic Disease Management
- Medication Adherence Studies
Background:
- Medication adherence is crucial for managing chronic diseases, yet nonadherence incurs substantial economic and clinical costs.
- Medication Therapy Management (MTM) services are designed to optimize drug therapy and boost patient adherence.
- Comprehensive Medication Management (CMM) is a key MTM service focused on improving patient outcomes.
Purpose of the Study:
- To assess the impact of face-to-face Comprehensive Medication Management (CMM) on medication adherence.
- The study focused on four major chronic disease medication classes: oral diabetes drugs, statins, ACE inhibitors/ARBs, and beta-blockers.
Main Methods:
- A retrospective analysis of pharmacy claims from continuously enrolled employees (2007-2011) in a Midwest health system was conducted.
- Medication adherence was measured by Proportion of Days Covered (PDC) comparing patients receiving CMM to a control group.
- Inclusion criteria required at least one prescription fill in both baseline and measurement periods (365 days pre- and post-index date).
Main Results:
- The CMM group demonstrated consistently higher and statistically significant PDC levels across all evaluated therapeutic classes compared to the control group.
- Multivariate analyses confirmed that CMM exposure was associated with increased PDC for statins, ACE inhibitors/ARBs, and beta-blockers.
- Logistic regression indicated that CMM patients had a significantly higher probability of achieving an 80% PDC threshold for statins, ACE inhibitors/ARBs, and beta-blockers.
Conclusions:
- Face-to-face CMM services demonstrably improve medication adherence rates.
- CMM represents an effective practice model for enhancing medication adherence.
- Insurers and health plan administrators are encouraged to adopt and promote CMM to improve patient adherence and outcomes.
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