Patient outcomes from implementing an enhanced services pharmacy network.

Area of Science:

• Health Services Research
• Pharmaceutical Sciences
• Health Economics

Background:

• Community pharmacies are increasingly involved in patient care beyond dispensing.
• Medication adherence, healthcare utilization, and spending are key metrics for evaluating healthcare interventions.

Purpose of the Study:

• To assess the impact of a community pharmacy network intervention on medication adherence, healthcare service utilization, and healthcare spending.
• To evaluate the effectiveness of enhanced pharmacy services and comprehensive initial pharmacy assessments (CIPA).

Main Methods:

• A quasi-experimental, difference-in-difference analysis was employed with a nonequivalent control group.
• Medicaid-enrolled patients in North Carolina were included, with intervention and propensity score-matched control groups.
• Outcomes measured included hospitalizations, emergency department visits, healthcare spending, and adherence to specific medication classes.

Main Results:

• Medication adherence increased significantly for renin-angiotensin system antagonists (RASA) and multiple medications for chronic conditions (MMCC) by 9.5% and 10.3%, respectively.
• Total medical spending showed a slower decline of 5.7%, primarily driven by a 9.6% slower decline in outpatient spending.
• Emergency department utilization also decreased more slowly by 4.8% relative to controls.

Conclusions:

• The community pharmacy intervention demonstrated a statistically significant improvement in medication adherence for RASA and MMCC.
• The intervention did not yield significant improvements in utilization and spending outcomes and may have worsened them.
• Further research is recommended to understand patient selection, implementation variations, and treatment effect heterogeneity in pharmacy interventions.