Dm4 Evaluation of Clinical Laboratory-Pharmacy Linkage Decision Support in the Use of Potassium Supplements

Abstract

OBJECTIVES: Determine if Medicare Part D beneficiaries who received telephone MTM services had:1) Decreased medication/health-related problems (MHRPs); 2) Improved medication adherence; and 3) Decreased total Part D drug costs when compared to a control group. METHODS: Part D beneficiaries from a Texas health plan participated. The Andersen Model was the theoretical framework. Independent variables were: predisposing factors (age, gender, and race); and need factors (number of medications and chronic diseases and medication regimen complexity (MRC). The health behavior (intervention) was MTM utilization. Outcomes were change (from baseline to 12-month follow-up) in: 1) Number of MHRPs; 2) Medication adherence measured by the medication possession ratio (MPR); and 3) Total drug costs. Descriptive and inferential statistical analyses were conducted. RESULTS: The intervention (nϭ60) and control (nϭ60) groups were not statistically different regarding age (71.2Ϯ7.5 vs.73.9Ϯ8.0), medications (13.0Ϯ3.2 vs.13.2Ϯ3.4), chronic diseases (6.5Ϯ2.3 vs.7.0Ϯ2.1) or MRC [(21.5 (range 8 -43) vs.22.8 (range 9 -42.5)], respectively. The majority (51%) were male in the intervention group but only 28% were male in the control group (pϭ0.009). At baseline, 4.8Ϯ 2.7 (intervention group) and 9.1Ϯ 2.9 (control group) MHRPs were identified and 2.2Ϯ2.0 and 7.3Ϯ3.0 MHRPs remained at the 12-month follow-up, respectively. Multivariate regression revealed that MHRPs decreased significantly (pϭ0.0120) among the intervention group when compared to the control group. There were no significant predictors of change in MPR. Total drug costs (change from baseline to follow-up) decreased by $588Ϯ$2,086 in the intervention group and increased by $207Ϯ$1,752 in the control group. A t-test indicated the cost difference between the 2 groups was significant (pϭ0.03), but the multivariate regression did not indicate significant predictors. CONCLUSIONS: A telephone MTM program positively impacted MHRPs. Unadjusted cost comparisons also showed cost savings among the intervention group. Future research should focus on understanding predictors that impact adherence and cost-related MTM outcomes.