Online Program

334150
Academic-community partnership to implement medication therapy management (MTM) services in rural Arizona communities improves safety for patients with complex chronic conditions


Tuesday, November 3, 2015

Melissa Johnson, PharmD, Medication Management Center, The University of Arizona College of Pharmacy Medication Management Center, Tucson, AZ
Rebecca Jastrzab, PharmD, Public Policy and Management, The University of Arizona College of Public Health, Tucson, AZ
Kate Johnson, RN, BSN, Medication Management Center, Tucson, AZ
Elizabeth Hall-Lipsy, JD, MPH, College of Pharmacy, University of Arizona, Tucson, AZ
Rose Martin, PharmD, Medication Management Center, The University of Arizona College of Pharmacy Medication Management Center, Tucson, AZ
Ann Taylor, MPH, MCHES, Center for Health Outcomes and Pharmacoeconomic Research, The University of Arizona College of Pharmacy, Tucson, AZ
Terri Warholak, PhD, Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ
Background: The University of Arizona College of Pharmacy Medication Management Center (UAMMC ) is a leader in providing clinical pharmacy services – Medication Therapy Management (MTM) – nationwide.  MTM sessions include comprehensive medication reviews to assess for: safety concerns (i.e., drug-drug interactions, drug-disease interactions, duplicate therapy), gaps in care, adherence to medications, and cost savings opportunities.  Follow-up reviews ensure concerns are addressed and complications are prevented.  UAMMC has implemented a pilot hybrid MTM program for rural Arizonans with chronic conditions.  This model relied on the relationship that rural facilities have with their patients in reinforcing and implementing recommended changes. 

Methods: UAMMC collaborated with five rural facilities (two community health centers and three independent pharmacies) to implement MTM services for patients with multiple chronic conditions, including diabetes mellitus and/or hypertension.  UAMMC met telephonically with partners to: build consensus on project goals, develop patient recruitment procedures, and develop strategies to facilitate participation. UAMMC pharmacists participated in regular telephonic patient conferences to: identify and resolve safety concerns and gaps in medication care and adherence, address medication cost and optimization, and identify adherence to national consensus preventive care treatment guidelines.  Information was shared with local providers.

Results: Patients (n=600) with diabetes, hypertension, or both were recruited. Medication safety outcomes measured included identifying: therapeutic duplications, interactions (e.g., drug-drug, drug-disease, and drug-age), dosing concerns and adverse drug reactions, and recommendations implemented.  Analysis occured across participating sites and included percentage of successful safety based interventions and rate of provider recommendation acceptance.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health

Learning Objectives:
Describe a community-academic partnership to provide medication therapy management (MTM) services to patients with complex chronic conditions living in rural Arizona communities. Assess the impact of a community-academic partnership to provide MTM services on medication-related patient safety outcomes including therapeutic duplications, interactions (e.g., drug-drug, drug-disease, and drug-age), dosing concerns and adverse drug reactions. Assess the acceptance rate and successful implementation of safety recommendations made.

Keyword(s): Chronic Disease Management and Care, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am pharmacist and have worked in Medication Therapy Management (MTM) for years. I have lead projects that aim to address health disparities and collaborate with local communities to do so.
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.