Maximizing medication therapy management services through a referral initiative

• Published in: American journal of health-system pharmacy 2012-07, Vol.69 (14), p.1234-1239
• Main Authors: Imberg, Audrey J, Swanoski, Michael T, Renier, Colleen M, Sorensen, Todd D
• Format: Article
• Language: English
• Subjects: Drug therapy; Follow-Up Studies; Humans; Medication Therapy Management - standards; Methods; Outpatient Clinics, Hospital - standards; Patient Discharge - standards; Pharmaceutical services; Pharmacists - standards; Referral and Consultation - standards; Retrospective Studies
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp110511

The implementation and effects of an initiative to refer patients to receive medication therapy management (MTM) services after hospital discharge are described. A check box to order an MTM appointment was added to the discharge medication order form printed for hospitalized patients in an integrated health system. Hospitalists were informed about MTM services and encouraged to refer hospitalized patients to the service who were at risk for adverse drug events or medication nonadherence. A retrospective case series review was conducted to evaluate documented MTM encounters, comparing the number of patients seen at the MTM practice for hospital follow-up during the four months before and after the initiative's implementation. Secondary endpoints included revenue generated by MTM encounters and the percentage of patients with documented drug therapy problems due to medication nonadherence. A total of 313 encounters were included in the analysis (142 preimplementation and 171 postimplementation). The percentage of MTM hospital follow-up encounters significantly increased from the preimplementation period to the post-implementation period, from 30.28% (n = 43) to 63.74% (n = 109) (p < 0.001). After the referral initiative was implemented, MTM hospital follow-up encounters were more likely to reveal medication nonadherence, compared with regular office visits (odds ratio, 2.1; 95% confidence interval, 1.01-4.34; p = 0.039). The implementation of an initiative to refer hospitalized patients to an MTM service in an integrated health system increased the percentage of recently discharged patients seen in an MTM practice; patients seen postimplementation were more likely to be nonadherent to their medication regimen.