Patient Satisfaction With Pharmacist-Led Chronic Disease State Management Programs.

PURPOSE: To assess patient satisfaction, perception of self-management, and perception of disease state knowledge with pharmacist-led diabetes and cardiovascular disease state management (DSM) programs. METHODS: A self-insured chain of grocery store pharmacies in the Kansas City metropolitan area administers pharmacist-led diabetes and cardiovascular DSM programs for eligible employees and dependents. A modified version of the Diabetes Disease State Management Questionnaire was used to assess patient satisfaction with the DSM programs. Demographic information was also collected. Survey items were based on a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree). Patients were eligible to complete the survey if he or she had been in at least 1 DSM program for 6 months. Data were assessed using descriptive statistics and analysis of variance. RESULTS: Across 20 pharmacies, 281 eligible participants were identified, and 46% (n = 128) completed a survey. Means for summed items relating to overall satisfaction (8 items), self-management (5 items), and knowledge (4 items) were 36.6/40 (standard deviation [SD] = 3.9), 20.9/25 (SD = 3.4), and 17.6/20 (SD = 2.1), respectively. Participant comments further indicated that the program and pharmacists are helpful and increase motivation and accountability. CONCLUSIONS: Positive patient responses to the program support use of pharmacist-led DSM programs.

Study of nonparticipation in an employee diabetes program.

OBJECTIVES: To determine factors that affect nonparticipation in an employee diabetes program and factors that may increase participation in future employee health programs. METHODS: Participants in this cross-sectional study were adults with type 1 or type 2 diabetes, 18 to 80 years of age, who were covered by employer insurance but chose not to participate in an employer-sponsored diabetes program. Potential factors affecting program participation were assessed through a face-to-face or mailed survey. RESULTS: Of 204 employees or their dependents eligible for the diabetes program, 75 (37%) chose not to participate. Among the nonparticipants, 46 (61%) were eligible for this study. A total of 22 surveys were collected for a 48% response rate. The majority of those individuals surveyed (91%) were aware of the diabetes program and had been notified by mail (42%) or phone (29%). Of those surveyed, 33% did not believe that program incentives had been sufficiently explained to them. Work schedule was not found to be a determinant of participation. More than one-half (52%) of responders identified satisfaction with their current diabetes management as the most notable reason for nonparticipation in the employee diabetes program. CONCLUSION: This study demonstrated that the primary reason for program nonparticipation was patient satisfaction with current physician management of their diabetes. In the future, companies offering health programs should emphasize that the program is being offered to supplement and complement current disease state management, not to replace it.

Community pharmacy-based medication therapy management services: financial impact for patients / Servicios de gestión de la medicación en farmacia comunitaria: impacto financiero para los pacientes

Objective: To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM) interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists’ recommended MTM interventions. Methods: This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-ofpocket prescription medication expense as a result of MTM services. Results: Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69)) while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48)). The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, p<0.0001). Pharmacists attempted a total of 732 recommendations; 391 (53%) were accepted by both the patient and their prescriber. A total of 341 (47%) recommendations were not accepted because of patient refusal (290, 85%) or prescriber refusal (51, 15%). Conclusions: Patient participation in MTM services reduces patient out-of-pocket medication expense. However, this savings is driven by only 32% of subjects who are experiencing a financial impact on out-of-pocket medication expense. Additionally, the majority of the pharmacists’ recommended interventions (53%) were accepted by patients and prescribers (AU)

Objetivo: Determinar el impacto financiero directo para los pacientes resultando de las intervenciones de Gestión de la Medicación (MTM) hechas por farmacéuticos comunitarios. Los objetivos secundarios incluían evaluar las tasas de aceptación por pacientes y médicos de las recomendaciones de MTM de los farmacéuticos. Métodos: Fue un estudio observacional retrospectivo realizado en 20 tiendas de la cadena de farmacias Price Chopper and Hen House de la zona metropolitana de Kansas City desde 1 de enero 2010 a 31 de diciembre 2010. Los pacientes en estudio eran beneficiarios de Medicare Part D elegibles para servicios de MTM. El resultado primario fue los cambios en gastos sufragados por los pacientes de la medicación prescrita como resultado de los servicios de MTM. Resultados: De los 128 pacientes incluidos en el estudio, el 68% no experimentó impacto en sus gastos en medicación como resultado de los servicios de MTM. Un 27% de los pacientes consiguió un ahorro (USD440,50 por año, (SD=289,69)) mientras que otro 5% de pacientes vio incrementado su gasto en medicación (USD255,66 por año, (SD=324,48)). El impacto financiero neto para los 128 pacientes que participaron en el estudio fue un ahorro medio de USD102,83 por paciente y año (SD=269,18; p<0,0001). Los farmacéuticos intentaron un total de 732 recomendaciones; 391 (53%) fueron aceptadas tanto por pacientes como por prescriptor. Un total de 341 (47%) recomendaciones no fueron aceptadas, por negativa del paciente (290; 85%) o por negativa del prescriptor (51; 15%). Conclusiones: La participación de los pacientes en servicios de MTM reduce el gasto en medicamentos del paciente. Sin embargo, este ahorro se materializa sólo en un 32% de pacientes que sufren impacto financiero. Asimismo, la mayoría (53%) de las intervenciones recomendadas por el farmacéutico fueron aceptadas por pacientes y prescriptores (AU)

Community pharmacy-based medication therapy management services: financial impact for patients.

OBJECTIVE: To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM) interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists' recommended MTM interventions. METHODS: This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-of-pocket prescription medication expense as a result of MTM services. RESULTS: Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69)) while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48)). The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, p<0.0001). Pharmacists attempted a total of 732 recommendations; 391 (53%) were accepted by both the patient and their prescriber. A total of 341 (47%) recommendations were not accepted because of patient refusal (290, 85%) or prescriber refusal (51, 15%). CONCLUSIONS: Patient participation in MTM services reduces patient out-of-pocket medication expense. However, this savings is driven by only 32% of subjects who are experiencing a financial impact on out-of-pocket medication expense. Additionally, the majority of the pharmacists' recommended interventions (53%) were accepted by patients and prescribers.