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Prescriber acceptance rate of pharmacists' recommendations
Objectives:
To determine the prescriber acceptance rates of pharmacists' recommendations, specifically related to 2 Medicare Part D Star ratings: appropriate use of high-risk medications (HRMs) in elderly patients and use of statins for primary prevention in patients with diabetes. The secondary objective was to assess factors associated with prescriber acceptance.
Design:
Retrospective cohort.
Setting And Participants:
Medicare Part D beneficiaries at a regional grocery store chain pharmacy in Michigan from January 2014 to October 2015.
Main Outcome Measures:
Prescriber acceptance rate of recommendations related to HRM use or treatment with a statin in patients with diabetes.
Results:
Data were collected and analyzed for 200 patients, of which 100 were recommended to discontinue an HRM (HRM group) and 100 were recommended statin therapy owing to diabetes (statin group). Out of the 200 pharmacist-initiated recommendations, 100 were directed to a prescriber and therefore included in the calculation of prescriber acceptance. Overall, 35.0% of those recommendations were accepted, with individual group rates of 58.9% (23/39) and 19.7% (12/61) in the HRM group and statin group, respectively. Patients who were prescribed a statin for primary prevention of cardiovascular events were more likely to have concurrent dyslipidemia.
Conclusion:
The prescriber acceptance rates observed in this study were similar to those reported in published literature. The results of this study might suggest that prescribers and patients with diabetes may be reluctant to initiate statin therapy for primary prevention without a concurrent diagnosis of dyslipidemia. Although further research is required, strategies to optimize communication and augment patient education may be useful to increase prescriber as well as patient acceptance of recommendations made by community pharmacists.