264010 Healthier and wealthier older adults took more action following medication safety reviews

Monday, October 29, 2012

Daniel Cook, PhD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Paula Moulton, MPH , Sanford Center for Aging, University of Nevada Reno, Reno, NV
Teresa Sacks, MPH , Sanford Center for Aging, University of Nevada Reno, Reno, NV
Wei Yang, PhD, MD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
BACKGROUND: Medication therapy management (MTM) services provide essential reviews of drug regimens that may improve patient safety, health outcomes, and cost savings. This study aimed to assess patient self-reported behaviors following receipt of a pharmacist report.

METHODS: Follow-up surveys of 482 elderly pharmacy services patients were analyzed with multiple logistic regressions.

RESULTS: The odds of discussing the medication review with physicians, making changes recommended in the report, and doing both discussing and making a change were 65%, 60%, and 67% lower among those below poverty level than among those above poverty level; 95% CIs [0.15, 0.80], [0.18, 0.85], and 0.15, 0.73], respectively. The odds of those reporting good or excellent health of doing the combination of discussing the MTM report with physicians and to make a drug regimen change were 2 times higher than the odds those reporting poor to fair health, 95% CI [1.08, 3.65]. The odds of those using high-risk drugs of making changes in drug regimens and of both discussing with physicians and making changes were two times higher than the odds of those not using these drugs, 95% CIs [1.02, 4.31] and [1.20, 4.87], respectively. Gender, ethnicity, age group, rural status, prescription drug insurance, and high polypharmacy were not significant factors for acting upon the medication review in the adjusted model.

CONCLUSION: MTM services are associated with enhanced patient self-advocacy, but like other interventions they are constrained by social disparities. Greater attention to the resources of target populations to respond to pharmacy services is merited.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
Describe medication therapy management services. Evaluate how patients with chronic disease drug regimens may respond to a pharmacist safety review. Compare demographics of patients with greater behavioral outcomes.

Keywords: Drug Safety, Disease Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am faculty in public health with a PhD in political science and certificate in health services research. I led the team that analyzed this survey data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.