Cost savings impact of a pharmacist-initiated teleservice program for Medicare Part D reviews.

OBJECTIVES: To (a) determine potential cost savings of a pharmacy outreach teleservice program conducting Medicare Part D plan reviews for a large population of beneficiaries allowing for comparison of multiple preferences; and (b) explore client demographic comparisons, plan features, and stratification by cost and number of medications. METHODS: Retrospective cohort evaluation of a Medicare D review service during open enrollment period (October 15 to December 7, 2012). Reviews were conducted at a university-based pharmacy outreach program in Massachusetts and completed by pharmacists (17%), case managers (52%), and students (31%). Recommendations were created by entering medication regimens into the Medicare.gov plan finder, and factors including deductible, premium, and copayment or coinsurance, formulary restrictions, secondary assistance, and annual cost were considered. A comparison of the overall cost of the client's 2012 plan in 2013 with that of a lower-cost plan in the 2013 benefit year determined potential cost savings. RESULTS: Demographic data were available for 1062 individuals, with the majority being women (66%), an overall mean age of 73 years, and most living in a single household. Clients (75%) were taking 5 or more medications. Lower-cost plans were recommended for 61% of clients with a median cost savings valued at $538 per member, per year. Cost was the leading consideration for plan change (87.4%), followed by deductible (32.7%) and premium (30.1%). Cost savings were analyzed by evaluating current plan versus alternate plan by sex, age, client type (repeat vs. referred vs. new), and according to number of medications. Lower-cost plans were identified for 75% of new members. Individuals taking 0-14 medications had a cost savings of approximately $833 per client per year. CONCLUSION: Teleservice pharmacy outreach programs create value by identifying therapeutically comparable alternative plans and reducing plan spending while efficiently consulting for a large number of Medicare Part D beneficiaries statewide.

Pharmacist consultations: simplifying daily drug regimens and providing education on fall risk for older adults.

OBJECTIVE: To evaluate whether a medication review by a pharmacist in the community can simplify an older adult's daily drug regimen and improve awareness of medication-related fall risk. DESIGN: Pre- and posttest with follow-up design. SETTING: Senior centers, senior housing facilities, and community centers in Massachusetts. PARTICIPANTS: Older adults who attended a pharmacy outreach program at a community center. INTERVENTIONS: Participants engaged in a one-time, face-to-face, medication therapy management (MTM) session. The pharmacists made recommendations to simplify daily drug regimens for best therapeutic results. The participants were educated regarding the influence that medications may have on fall risk. RESULTS: For the 75 participants, daily dose regimens were significantly reduced. From the presurvey to the follow-up surveys, there was a significant increase of participants taking medication three times or fewer per day (73% to 85%) versus those participants taking medications more than three times per day (P = 0.041). Through MTM consultations, participants' awareness that medications may be a contributing factor to fall risk was increased from 28% in the presurvey to 56% in the postsurvey (P = 0.0018). CONCLUSION: A pharmacist consultation can simplify the daily drug regimen. Furthermore, consultant pharmacists can educate patients regarding the risk that medications may have on falls.

Expanding clinical and information services to the ambulatory older adult through community outreach programs.

OBJECTIVE: To share successful techniques pharmacists can use to educate community-based older adults about health and medications. SETTING: Events coordinated through MCPHS University Pharmacy Outreach Program and offered at Massachusetts senior centers. PRACTICE DESCRIPTION: The MCPHS University Pharmacy Outreach Program, staffed with pharmacists, caseworkers, and pharmacy students, under the supervision of licensed pharmacists, provides free medication-related information to Massachusetts residents. Clients also receive assistance with cost-minimizing programs and insurance benefits. Seventy percent of contacts are older adults. Services are provided through a toll-free number and outreach programs. PRACTICE INNOVATION: Focus on expanding educational health services and includes selecting Medicare D plans, working with support groups, providing medication management for diverse cultures, educating older adults on how to search for health information on the Internet, and discussing medication safety and adherence. MAIN OUTCOME MEASUREMENTS: Participant and pharmacy student knowledge assessed utilizing survey tools. Additional measurements include savings for Medicare beneficiaries and improvements in medication management. RESULTS: Observed results of the Pharmacy Outreach Program include decreased out-of-pocket costs for Medicare beneficiaries, improved medication adherence resulting in reduction of glycated hemoglobin and blood pressure, identifying and recommending medication treatment changes to reduce patient fall risk, and increased confidence in locating Web-based health information. Pharmacy students demonstrated increased knowledge of and ability to communicate Medicare benefits. CONCLUSION: Outreach programs can improve older adults' understanding about their health and medications. Pharmacists can increase visibility in the community by engaging in effective outreach programs.

Interprofessional education with a community fall prevention event.

Implementation of interprofessional education (IPE) among multiple professional degree programs has many challenges. Students from four health science programs: pharmacy; nursing; physician assistant studies and physical therapy participated in an interprofessional community fall prevention event. This paper briefly describes the development of this IPE opportunity and the assessment of changes on students' attitudes about IPE after participation in the event. Differing views on teamwork and professional roles are reported by professions. Positive attitudes towards interprofessional teamwork were observed after participation in the event. Based on these data, it appears that an interprofessional community service event offers a useful approach forward for incorporating IPE into the curricula of different health care programs.