ABSTRACT
OBJECTIVES: To propose a metric evaluating the quality of comprehensive medication reviews (CMRs), and to discuss the optimal setting for CMR delivery. SUMMARY: First, we provide a current assessment of the quality of CMRs performed in community, payer, and health system/clinic settings, with recommended opportunities for improvement. Thereafter, a companion metric for CMR quality is discussed, because this is critical to ensuring that patients are not just receiving CMR services, but that CMRs reflect evidence-based recommendations supporting optimal patient outcomes. CONCLUSION: Based on the data currently available, accessibility to electronic medical records would enhance patient-specific recommendations to optimize CMR delivery and patient outcomes. Future studies may help to identify additional factors, such as pharmacist-physician collaboration in clinic and use of evidence-based recommendations, that can further enhance CMR quality.
Subject(s)
Community Pharmacy Services/organization & administration , Quality Assurance, Health Care/standards , Electronic Health Records , Humans , Medicare Part D/standards , Medication Therapy Management/organization & administration , Patient Outcome Assessment , United StatesSubject(s)
Drug Monitoring , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Metformin/adverse effects , Metformin/therapeutic use , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Drug Utilization Review , Female , Glycated Hemoglobin/analysis , Heart Failure/complications , Humans , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Insulin/therapeutic use , Male , Metformin/administration & dosage , Middle Aged , Practice Guidelines as Topic , Retrospective Studies , Sulfonylurea Compounds/administration & dosage , Sulfonylurea Compounds/therapeutic useABSTRACT
Patients who had an acute myocardial infarction or other atherosclerotic event and had filled a prescription for an HMG-CoA reductase inhibitor were identified for analysis. Compliance was assessed using a multiple-interval refill compliance score. The mean compliance score was 80% and six refill patterns were identified. Regression analysis revealed three factors associated with compliance: (1) days' supply, (2) number of total concomitant medications, and (3) cost sharing. Strategies for improving compliance that may have merit include providing patients with 60- or 90-day supplies (rather than 30-day supplies), controlling the number of other medications prescribed, and lowering copayments for these important medications.
