Comprehensive Medication Management Could Be Key to Reducing Cost, Improving Chronic Disease Markers

Clinical markers of chronic disease may be improved by ambulatory care pharmacists engaging in comprehensive medication management. Little is known about the explicit financial value that such care can produces. A poster presented by Anna Pham, PharmD, of Intermountain Healthcare in Salt Lake City, Utah, at the American Society of Health System Pharmacists 2022 Summer Meeting and Exhibition in Phoenix, Arizona, examined the impact of value of such services in an integrated health system.

Investigators matched study participants 1:2 into an experimental cohort comprised of patients taking medication for chronic diseases who worked with an ambulatory care pharmacists and a control cohort of patients who did not. Intervention patients were eligible for inclusion if they had at least 2 comprehensive medication management appointments at least 3 months apart with an ambulatory care pharmacist from January 2020 to December 2020;control patients were eligible if they had 2 primary care visits at least 3 months apart in the same time period.

The primary outcome was the utilization of the emergency department and hospital from January 2020 to December 2020. Secondary outcomes included the cost savings analysis of emergency department and hospital use data as well as a comparison of disease markers before and after the interventions.

The cohort included 300 patients: 100 in the intervention group and 200 in the control group. A look at health system utilization found an average of 7.1 emergency department visits per 1000 patients in the intervention cohort vs11.4 in the control (P=.018). Furthermore, the control group had an average of 5.0 inpatient per 1000 patientsvs3.1 in the intervention group (P<.01).

Using estimated admission costs, the differences in admission represent a reduction of $46,574 for the emergency department and $306,912 for inpatient visits with the aid of pharmacist intervention. No statistical differences were seen between the 2 groups for blood pressure and lipid panels, but the intervention group did see an average reduction in HbA1c from 8.97% before comprehensive medication management to 7.95% (P<.01) after a year, whereas the control group saw an average increase from 8.85% to 9.37% (P<.43) in the same time span.

“[Comprehensive medication management] provided by ambulatory care pharmacists were shown to reduce ED and inpatient visits…which may lead to monetary savings to the health system,” the author concluded.

Reference

PhamA. Impact and value of ambulatory care pharmacists’ clinical interventions within primary care clinics. Presented at American Society of Health-SystemPharmacists 2022 Summer Meeting and Exhibition; June 11-15, 2022; Phoenix, AZ. Poster 7-T.