jueves, 9 de enero de 2020

Factors associated with comprehensive medication review completion rates: A national survey of community pharmacists. - PubMed - NCBI

2019 Aug 2. pii: S1551-7411(19)30383-3. doi: 10.1016/j.sapharm.2019.08.008. [Epub ahead of print]

Factors associated with comprehensive medication review completion rates: A national survey of community pharmacists.

Snyder ME1, Jaynes HA2, Gernant SA3, Lantaff WM4, Doucette WR5, Hudmon KS6, Perkins SM7.

Author information

1: Purdue University College of Pharmacy, Fifth Third Bank Building, 640 Eskenazi Avenue, Indianapolis, IN, 46202, USA. Electronic address: snyderme@purdue.edu.
2: Purdue University College of Pharmacy, Fifth Third Bank Building, 640 Eskenazi Avenue, Indianapolis, IN, 46202, USA. Electronic address: hrwoblew@iu.edu.
3: University of Connecticut School of Pharmacy, 69 North Eagleville Rd, U-3095, Storrs, CT, 06269, USA. Electronic address: Stephanie.gernant@uconn.edu.
4: Eudaemonia Health, LLC, USA; Walmart Pharmacy, USA. Electronic address: wendylantaff@gmail.com.
5: University of Iowa College of Pharmacy, S518 PHAR, 115 S. Grand Ave., Iowa City, IA, 52242, USA. Electronic address: William-doucette@uiowa.edu.
6: Purdue University College of Pharmacy, Fifth Third Bank Building, 640 Eskenazi Avenue, Indianapolis, IN, 46202, USA. Electronic address: khudmon@purdue.edu.
7: Indiana University School of Medicine, Department of Biostatistics, HITS HS3023 BSAT, Indianapolis, IN, 46202, USA. Electronic address: sperkin1@iu.edu.

Abstract

BACKGROUND:

Completion rates for medication therapy management (MTM) services have been lower than desired and the Centers for Medicare and Medicaid Services has added MTM comprehensive medication review (CMR) completion rates as a Part D plan star measure. Over half of plans utilize community pharmacists via contracts with MTM vendors.

OBJECTIVES:

The primary objective of this survey study was to identify factors associated with the CMR completion rates of community pharmacies contracted with a national MTM vendor.

METHODSL:

Representatives from 27,560 pharmacy locations contracted with a national MTM vendor were surveyed. The dependent variable of interest was the pharmacies' CMR completion rate. Independent variables included the pharmacy's progressiveness stratum and number of CMRs assigned by the MTM vendor during the time period, as well as self-reported data to characterize MTM facilitators, barriers, delivery strategies, staffing, selected items from a modified Assessment of Chronic Illness Care, and pharmacist/pharmacy demographics. Univariate negative binomial models were fit for each independent variable, and variables significant at p < 0.05 were entered into a multivariable model.

RESULTS:

Representatives from 3836 (13.9%) pharmacy locations responded; of these, 90.9% (n = 3486) responses were useable. The median CMR completion rate was 0.42. Variables remaining significant at p < 0.05 in the multivariable model included: progressiveness strata; pharmacy type; scores on the facilitators scale; responses to two potential barriers items; scores on the patient/caregiver delivery strategies sub-scale; providing MTM at multiple locations; reporting that the MTM vendor sending the survey link is the primary MTM vendor for which the respondent provides MTM; and the number of hours per week that the pharmacy is open.

CONCLUSIONS:

Factors at the respondent (e.g., responses to facilitators scale) and pharmacy (e.g., pharmacy type) levels were associated with CMR completion rates. These findings could be used by MTM stakeholders to improve CMR completion rates.