Comparative Effectiveness of Medication Therapy Management Eligibility Criteria Across Racial/Ethnic Groups

Spivey, Christina A.; Qiao, Yanru; Wang, Junling; Shih, Ya Chen Tina; Wan, Jim Y.; Dagogo‐Jack, Samuel; Cushman, William C.; Hines, Lisa; Chisholm-Burns, Marie A.

doi:10.1111/jgs.15754

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…So the oncologists eagerly expect the involvement of multi-disciplinary experts especially the pharmacists to manage the tumor patients to take medications (23)(24)(25). Fortunately, our clinical pharmacists have been receiving training since the introduction of the MTM mode from USA in 2015 (26)(27)(28). In phase I, we established the first anti-neoplastic MTM system in Shanghai in 2018 with the cooperation of oncologists, clinic pharmacists and software engineers.…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness of an independent anti-neoplastic medication therapy management system in ambulatory cancer patients

Zhang¹,

Xu²,

Zhao³

et al. 2021

Transl Cancer Res TCR

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Background: Cancer has always been a serious health threat for human. Patients with cancer are at high risk of drug-related problems (DRPs) due to multi-morbidity associated polypharmacy. However, data is lacking in identifying and addressing potential DRPs in cancer patients in China. This study aims to investigate the prevalence of DRPs and evaluate the effectiveness of an independent anti-neoplastic medication therapy management (MTM) system in ambulatory cancer patients.Methods: This is a retrospective study. An independent anti-neoplastic MTM system in Shanghai Jiao Tong University affiliated sixth People's Hospital was established in 2018 with the collaboration of oncologists, clinical pharmacists and software engineers. The system contains an independent clinic of pharmacy and MTM software. The software consisted of six modules to help clinical pharmacists serve the tumor patients. The six modules include medication therapy review, intervention plan, personal medication record, medication-related action plan, intervention and/or referral, and documentation and follow-up.Results: A total of 173 eligible tumor patients visited the anti-neoplastic pharmaceutical clinic and were recorded in the independent anti-neoplastic MTM system from Jun 2018 to May 2019. The average clinic visits were 2.4 times of the study participants. Two thirds patients (117/173) had one or more identified DRPs in medication therapy review. Adverse drug reaction, potential drug interaction and non-adherence were the leading DRPs. 85.8% of DRPs could be resolved (cured or improved) in four weeks. Tumor patients showed medication adherence reached 84-100% after three or four times of follow-up and intervention. Conclusions:The participation of clinical pharmacists in managing polypharmacy tumor patients, with the independent anti-neoplastic MTM system, facilitated the identifying and solving DRPs, especially improving medication adherence of patients, and thus enhancing the effectiveness, safety and rational use of medication.

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Section: Discussionmentioning

confidence: 99%

“…Fortunately, our clinical pharmacists have been receiving training since the introduction of the MTM mode from USA in 2015 ( 26 - 28 ). In phase I, we established the first anti-neoplastic MTM system in Shanghai in 2018 with the cooperation of oncologists, clinic pharmacists and software engineers.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of an independent anti-neoplastic medication therapy management system in ambulatory cancer patients

Zhang¹,

Xu²,

Zhao³

et al. 2021

Transl Cancer Res TCR

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“…Prior studies 10 , 11 have examined patient characteristics associated with offer and completion of a CMR in 2013 to 2016 as well as racial, ethnic, and socioeconomic disparities in Medicare minimum thresholds for MTM eligibility criteria. 12 , 13 , 14 Specifically, Black and Hispanic beneficiaries were found to be less likely to meet Medicare minimum thresholds for MTM eligibility criteria, 12 , 13 , 14 and low-income beneficiaries were less likely to be offered a CMR, as well as complete a CMR, if offered. 10 , 11 …”

Section: Introductionmentioning

confidence: 95%

Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure

Hung,

Wilson,

Smith

et al. 2024

JAMA Health Forum

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ImportanceComprehensive medication reviews (CMRs) are offered to qualifying US Medicare beneficiaries annually to optimize medication regimens and therapeutic outcomes. In 2016, Medicare adopted CMR completion as a Star Rating quality measure to encourage the use of CMRs.ObjectiveTo examine trends in CMR completion rates before and after 2016 and whether racial, ethnic, and socioeconomic disparities in CMR completion changed.Design, Setting, and ParticipantsThis observational study using interrupted time-series analysis examined 2013 to 2020 annual cohorts of community-dwelling Medicare beneficiaries aged 66 years and older eligible for a CMR as determined by Part D plans and by objective minimum eligibility criteria. Data analysis was conducted from September 2022 to February 2024.ExposureAdoption of CMR completion as a Star Rating quality measure in 2016.Main Outcome and MeasuresCMR completion modeled via generalized estimating equations.ResultsThe study included a total of 561 950 eligible beneficiaries, with 253 561 in the 2013 to 2015 cohort (median [IQR] age, 75.8 [70.7-82.1] years; 90 778 male [35.8%]; 6795 Asian [2.7%]; 24 425 Black [9.6%]; 7674 Hispanic [3.0%]; 208 621 White [82.3%]) and 308 389 in the 2016 to 2020 cohort (median [IQR] age, 75.1 [70.4-80.9] years; 126 730 male [41.1%]; 8922 Asian [2.9%]; 27 915 Black [9.1%]; 7635 Hispanic [2.5%]; 252 781 White [82.0%]). The unadjusted CMR completion rate increased from 10.2% (7379 of 72 225 individuals) in 2013 to 15.6% (14 185 of 90 847 individuals) in 2015 and increased further to 35.8% (18 376 of 51 386 individuals) in 2020, in part because the population deemed by Part D plans to be MTM-eligible decreased by nearly half after 2015 (90 487 individuals in 2015 to 51 386 individuals in 2020). Among a simulated cohort based on Medicare minimum eligibility thresholds, the unadjusted CMR completion rate increased but to a lesser extent, from 4.4% in 2013 to 12.6% in 2020. Compared with White beneficiaries, Asian and Hispanic beneficiaries experienced greater increases in likelihood of CMR completion after 2016 but remained less likely to complete a CMR. Dual-Medicaid enrollees also experienced greater increases in likelihood of CMR completion as compared with those without either designation, but still remained less likely to complete CMR.Conclusion and RelevanceThis study found that adoption of CMR completion as a Star Rating quality measure was associated with higher CMR completion rates. The increase in CMR completion rates was achieved partly because Part D plans used stricter eligibility criteria to define eligible patients. Reductions in disparities for eligible Asian, Hispanic, and dual-Medicaid enrollees were seen, but not eliminated. These findings suggest that quality measures can inform plan behavior and could be used to help address disparities.

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“…Moreover, because the MTM eligibility criteria are based primarily on prescription drug cost and medication use, racial/ ethnic minorities may be disproportionately affected because minorities historically use fewer prescription drugs and spend less money on medications compared with Whites. 6 To date, it is unclear if the observed racial/ethnic disparities in MTM eligibility are seen in those who actually receive MTM services because socioeconomic and geographical characteristics of those who received MTM services are not readily available. The objective of this study was to describe the demographic and geographic characteristics of a convenience sample of Medicare beneficiaries who received MTM services.…”

Section: Understanding the Socioeconomic And Geographical Characteristics Of Beneficiaries Receiving A Comprehensive Medication Reviewmentioning

confidence: 99%

“…The MTM eligibility criteria may perpetuate racial/ethnic disparities in access to health care services. 5,6,23 In addition, sociocultural differences between patients and health care professionals can result in a lack of understanding between the 2 parties. 13 If these differences are not fully accepted or embraced, cultural or linguistic barriers arising from the health care system may result in a negative effect on communication and trust, encouraging certain racial/ethnic groups to decline health care services.…”

Section: Understanding the Socioeconomic And Geographical Characteristics Of Beneficiaries Receiving A Comprehensive Medication Reviewmentioning

confidence: 99%

Understanding the Socioeconomic and Geographical Characteristics of Beneficiaries Receiving a Comprehensive Medication Review

Chou

Pellegrin

Cooke

et al. 2020

JMCP

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BACKGROUND: Medicare Part D sponsors are required to offer medication therapy management (MTM) programs to eligible beneficiaries. Recent studies have demonstrated that there have been racial/ethnic disparities in MTM eligibility criteria. For example, compared with non-Hispanic White beneficiaries, Hispanic and non-Hispanic Black beneficiaries are less likely to be eligible for MTM. However, there is limited evidence for socioeconomic and geographical characteristics of those who are eligible and receive MTM services. OBJECTIVE: To describe the demographic, socioeconomic, and geographic characteristics of Medicare beneficiaries who received MTM services. METHODS: As part of a previous study, a national survey evaluated a convenience sample of perspectives of Medicare beneficiaries on the MTM standardized format. The survey was distributed through Medicare Part D plans to beneficiaries receiving MTM services from 2017-2018. As part of the survey, respondents could provide their ZIP codes. Geographical variables, such as the National Center for Health Statistics (NCHS) urbanrural classification scheme and economic research service (ERS) county typology codes, were then applied to respondents' ZIP codes, allowing for the classification of counties or census tracts by urbanization and economic dependence measures. Descriptive statistics are reported for demographic, geographical, and socioeconomic information.RESULTS: Of the 300 (of 434) respondents who provided their ZIP codes, 51.3% were aged 65-74 years; 50% were male; and 66.7% had at least a college education. There were 82.7% who self-identified as White, while only 8% self-identified as Hispanic or Black/African American. The majority of respondents (58.4%) lived in large metropolitan areas as defined by the NCHS urban-rural classification scheme. Respondents' counties were characterized by economic dependence with 14.0% of respondents living in federal/state government-dependent counties and 12.7% living in recreation-dependent counties.CONCLUSIONS: The majority of respondents who provided their ZIP codes identified themselves as White and lived in large metropolitan areas. Respondents who identified themselves as Hispanic or Black/African American were not well represented. This study provides geographical and socioeconomic characteristics of Medicare beneficiaries who received MTM services and highlights racial/ethnic differences. Further work is needed to confirm geographical and socioeconomic disparities among beneficiaries who received MTM services.

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Comparative Effectiveness of Medication Therapy Management Eligibility Criteria Across Racial/Ethnic Groups

Cited by 6 publications

References 15 publications

The effectiveness of an independent anti-neoplastic medication therapy management system in ambulatory cancer patients

The effectiveness of an independent anti-neoplastic medication therapy management system in ambulatory cancer patients

Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure

Understanding the Socioeconomic and Geographical Characteristics of Beneficiaries Receiving a Comprehensive Medication Review

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