Medicare beneficiary feedback on information provided by pharmacists during consultative services

Background: Optimal medication use is contingent upon comprehensive medication consultation. Purpose: To examine factors that impact information provided during a pharmacist consultation in an ambulatory Medicare population. Methods: Twelve community health fairs targeting Medicare beneficiaries were held in cities across Central/Northern California during the 2013 Medicare open enrollment period. Beneficiaries were asked which critical elements of a consultation were typically discussed by their community pharmacist. Demographic, socioeconomic and health-related data were collected and differences in information reported during a consultation were examined as a function of these variables. Results: Of the 647 beneficiaries who were offered Medication Therapy Management services, 532 completed survey questions regarding pharmacist consultation. Respondents stated a typical consultation included the following: 378 (71%) medicine name and indication; 361 (67.7%) how and when to take the medication and for how long; 307 (58%) side effects; 257 (48%) what to do if a dose is missed; and 245 (46%) if it is safe to take with other medication. Subsidy-recipients and those who spoke a language other than English were less likely to be counseled on drug name and indication (p<0.008) or side effects (p<0.006). Health conditions including benign prostatic hypertrophy (p=0.01), cancer (p=0.03), dementia (p=0.03) and incontinence (p=0.01) were associated with missing elements during the consultation. Conclusions: Critical elements of medication consultation were omitted between 29% and 52% of the time. Socioeconomic and demographic factors impacted whether a comprehensive consultation was provided. Additionally, certain health conditions may be more difficult to discuss in the community pharmacy setting.