White Papers and Issue Briefs

Avoidable illness and death resulting from non-optimized medication therapy cost $528.4 billion in 2016, according to a peer-reviewed paper in the Annals of Pharmacotherapy. That represents 16% of the annual $3.2 trillion the U.S. spends on health care. This issue brief from Health2 Resources explores the research behind the figures and discusses the promise of comprehensive medication management as a systematic approach that can assure medications are appropriately and effectively used–making them both cost effective and assuring that all conditions are effectively managed with fewer side effects.

Featuring the voices of Terry McInnis, MD, MPH, president and co-founder, Get the Medications Right Institute and Foundation; president, founder, Blue Thorn Inc.; and Jonathan H. Watanabe, Pharm.D., M.S., Ph.D. BCGP, associate professor of clinical pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego.

Defining an intervention and ensuring consistency in delivery is necessary to establish a common understanding and set of expectations across key stakeholder groups including patients, pharmacists, physicians, other health care providers, and payers. This also allows the service to be recognized as distinct, yet complementary to care provided by the primary or specialty care provider. An intervention, such as comprehensive medication management (CMM), focused on optimizing medication use must be defined with a degree of specificity that allows consistent training of clinical pharmacists and other health care providers, replication of the service, and observable fidelity of the service across practitioners.

This white paper provides a framework and common language for understanding CMM and delivering it through a detailed patient care process. It was funded by the American College of Clinical Pharmacy, the American College of Clinical Pharmacy Research Institute and the UNC Eshelman Institute for Innovation. Content was developed by researchers at the UNC Eschelman School of Pharmacy, University of Minnesota College of Pharmacy and the University of Colorado.

• Goodrich Pharmacy has 18 pharmacists at seven sites; five sites provide CMM. In 2015, they saw roughly 900 CMM patients and 700 disease-state medication management patients. Goodrich also contracts with six primary care clinics, providing CMM patient consultations for a flat fee. Steve Simenson, BPharm, FAPhA, DPNAP, is president and managing partner.

It’s long past the time to talk about “pilots” or “emerging practices” when discussing comprehensive medication management (CMM). CMM programs have been tested and retested, the results studied and documented. It’s not emerging: It has emerged—as a practice to improve outcomes, control costs and enhance the satisfaction of clinicians and patients alike. Health systems, patients, physicians—even payers—are beginning to understand the value of advanced clinical pharmacy services and the importance of integrating those services collaboratively into community/ambulatory team-based care, explains Terry McInnis, MD, MPH, CPE, FACOEM, in this white paper.