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Home > Disease Management
Improving Medication Adherence Through the Medical Home Model
Improving Medication Adherence Through the Medical Home Model
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As the command post for chronic care management, the patient-centered medical home (PCMH) is custom-built to break down barriers to medication adherence and reduce associated costs and clinical consequences — especially those linked to coronary artery disease (CAD), hypertension and diabetes.

Feedback from PCMH adopters reflects the potential of this care model. In a March 2010 e-survey on the PCMH conducted by the Healthcare Intelligence Network, more than two-thirds of healthcare respondents utilizing the PCMH model reported an increase in medication adherence in its population, and more than 35 percent now include a pharmacist on their medical home care team.

With approximately half of the population using at least one prescription medication and nearly three-quarters of all physician office visits involving medication therapy, how can the medical home raise medication adherence and compliance levels, and what are the potential financial gains to be realized? Improving Medication Adherence Through the Medical Home Model answers these questions by prescribing effective tactics and disease-specific success stories for in-house management of medication therapy — from the use of technology to drafting a pharmacist — virtual or co-located — to the medical home team.

This 40-page special report delivers collaborative, team-based approaches from Kaiser Permanente and others on the benefits of managing medication therapy from inside the PCMH. Beth Chester, PharmD, MPH, BCPS, senior director of clinical pharmacy services and quality for Kaiser Permanente Colorado, sketches out the roles of the physician practice staff and pharmacist in medication management, the use of technology and key financial incentives and reimbursement strategies that can improve payoffs from medication compliance.

Additionally, Jan Berger, MD, chief medical officer for Silverlink Communications, Inc., offers two team-based models for medication adherence improvement — one that includes the pharmacist on the care team and another that incorporates technology.

This report provides details on the following:

  • The rationale for including pharmacists in the medical home;
  • Medication therapy management practice examples that are improving patient care;
  • Overcoming the challenges associated with medication therapy management;
  • Results from a Kaiser Permanente Colorado program to improve medication adherence levels in patients with CAD;
  • Details on Kaiser's clinical pharmacy call center, which fields more than 200,000 medication-related calls per year;
  • Results and challenges from Kaiser's Safe Transitions program for patients being discharged home from an SNF;
  • Strategies, tools and technologies to improve medication and care plan adherence;
  • Closing gaps in care with communication and a personalized patient approach;
  • Creating a health plan design and co-payment structure that drives care plan and medication adherence;
  • Identifying and overcoming barriers to patients getting appropriate care;
  • The impact of a contract for care between patients with diabetes, their employer and their pharmacist on hospitalization, ER visits, absenteeism and other metrics;
  • How providing barrier-breaking tips to patients non-adherent with statins affected adherence levels;
and much more. A comprehensive Q&A section rounds out the roles of the provider, nurse, employer and patient in improving medication adherence and explores the impact of technology, medication packaging and more in adherence and compliance.

Table of Contents

  • Medication Therapy Management in the Patient-Centered Medical Home
    • Argument for Pharmacist-Led MTM
    • Responsibilities of the Clinical Pharmacy Team
    • Virtual Pharmacy Team Members
    • Cardiac Care Program Results
    • Safe Transitions SNF Discharge Program
    • Safe Transitions Results and Challenges
  • Achieving Medication and Care Plan Adherence through an Integrated Care Team
    • Provider-Patient Communications
    • Polk County’s Team-Based Approach
    • Clinical and Cost Improvements
    • Impact on Medication Adherence
  • Q&A: Ask the Experts
    • The Impact of Packaging on Medication Adherence
    • Reimbursing Pharmacists for MTM
    • Role of the Community Pharmacist in MTM
    • Physician Time Freed Up by Pharmacist
    • MTM Delivery Methods
    • MTM Session Frequency and Duration
    • Porting the Integrated System Model to a Network Model
    • First Steps to Program Launch
    • Dedicated Pharmacist Services
    • Measuring Effectiveness of MTM
    • MTM Data Management Software
    • ROI from MTM
    • Nurse Communication Methods
    • When to Involve the Community Pharmacist
    • Technology-Based Interventions
    • Community Partnerships
    • Measuring Medication Adherence
    • Care Team-Patient Communication Strategies
    • Boosting Patient Compliance
  • Glossary
  • For More Information
  • About the Presenters
Publication Date: July 2010
Number of Pages: 35
ISBN 10: 1-936186-32-2 (Print version); 1-936186-33-0 (PDF version)
ISBN 13: 978-1-936186-32-7 (Print version); 978-1-936186-33-4 (PDF version)
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