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Practice Transformation

Noah Nesin, MD, FAAFP, chief medical officer at Penobscot Community Health Care, writes on the importance clinical pharmacists, as part of the care team, have taken on as front-line responders during the current pandemic in the Journal of Ambulatory Care Management: “As the nature of primary care has become more complex and we have properly moved to include population health as a key responsibility, this now widely held perspective has become more and more evident: patient-centered primary care should be delivered by a team of professionals with complementary expertise and skills.” (Journal of Ambulatory Care Management)
During the pandemic, providers have increased their use of ePrescribing, direct messaging and prescription price-transparency tools, according to a recent Surescripts report. The decrease in ambulatory care visits and an increase in remote ones appear to have led health organizations and clinicians to better leverage health IT and EHRs to provide optimal care to patients. Increasing concerns about costs may be another driver: Use of the Real-Time Prescription benefit tool increased 19% percent since December. This EHR-embedded tool gives access to therapeutic alternatives, real-time prescription costs and coverage details to its users. (EHR Intelligence)

Evidence & Innovation

Liver toxicity has caused many drug failures, but scientists—working on something else—discovered a gene test that may predict the risk of medications that cause liver injury. Writing in Nature Medicine, they report identifying a polygenic risk score that shows when a drug poses a risk of drug-induced liver injury. The risk score takes more than 20,000 gene variants into account. Once the test is available, a clinician could run a quick genetic test to identify patients at higher risk of liver injury before prescribing medications. For researchers doing drug research, the test could help exclude people at high risk of liver injury from a clinical trial so the benefits of a medication can be more accurately assessed. (Nature Medicineannouncement)
GoodRx, which is preparing to go public, is “insanely profitable,” Adam J. Fein, PhD, writes in Drug Channels. He credits—or blames—the current crazy drug channel system. “Think about it this way: GoodRx profits by helping consumers avoid the U.S. pharmacy industry’s historical cash pricing models.” With no credible disruption in pricing, GoodRx will thrive. He dismisses the notion that Amazon is a disrupter. If it were, it would sell low-cost generics at cost-plus pricing. If other pharmacies followed suit, “GoodRx would cease to exist. But we’ve seen that Amazon can’t or won’t commit to changing the pharmacy channel.” (Drug Channels)
Cognitively normal people who took at least one anticholinergic drug were 47% more likely to develop mild cognitive impairment over a 10-year period than those who did not. Anticholinergic drugs are used for various conditions, including motion sickness and Parkinson’s disease. Some are available over-the-counter. “Our findings suggest that reducing the use of anticholinergic drugs before people develop any cognitive problems may be an important way to prevent the negative consequences of these drugs on thinking skills, especially for people who have an elevated risk of developing Alzheimer’s disease,” said study author Lisa Delano-Wood, PhD. Of note: Many of the subjects were taking the medications at higher-than-recommended levels for seniors. (Neurologyannouncement)

Policy Solutions

In a meeting last month with the Office of the National Coordinator for Health IT, industry groups stressed the importance of a patient-identification strategy during the epidemic. “Having incorrect data has a negative impact on the timeliness of the public health response,” HIMSS VP Tom Leary said during the meeting. It can lead to inaccuracies in the longitudinal care record, delays in sharing test results, data collection gaps and more. The House voted to remove the ban; a Senate vote is pending. (Healthcare IT News)

In Case You Missed It!

CMM offers reduced costs, improves access to care, provides better care and enhances provider work life. These results are outlined in “The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A Review of the Evidence on Quality, Access and Costs,” updated in June 2020. The evidence document was prepared by GTMRx workgroup members, M. Shawn McFarland, PharmD, FCCP, BCACP, national clinical pharmacy practice program manager, clinical practice integration and model advancement, clinical pharmacy practice office, pharmacy benefits management services, Veterans Health Administration; and Marcia Buck, PharmD, FCCP, FPPAG, BCPPS, director, clinical practice advancement, American College of Clinical Pharmacy. (GTMRx Institute)
Hosted by the GTMRx Institute’s executive director and co-founder, Katherine H. Capps, Voices of Change features leaders who have knowledge, experience and ideas to solve this urgent need to get the medications right. Did you miss the most recent episode?
Episodes feature:
  • Liz Fowler, JD, Ph.D., executive vice president for programs, The Commonwealth Fund
  • Amy Gutierrez, Pharm.D.,senior vice president and chief pharmacy officer, Kaiser Permanente
  • Amanda Brummel, PharmD, BCACP, vice president, Clinical Ambulatory Pharmacy Services, Fairview Pharmacy Services
  • Orsula V. Knowlton, PharmD, MBA, president and chief marketing & new business development officer, Tabula Rasa HealthCare
  • Anand Parekh, MD, chief medical advisor, Bipartisan Policy Center
  • Paul Grundy, MD, president, GTMRx; chief transformation officer, Innovaccer
AmazonSmile is an easy way for 0.5% of your qualified purchases go to the GTMRx Foundation at no cost to you. And signing up is simple—go to and select “Get the Medications Right Foundation” as your charity of choice. If you prefer to directly donate instead, you can do so here.
Adding the foundation on AmazonSmile will help us continue to provide no cost educational webinars, issue briefs, weekly news briefs and promote the need for transformation of our current system of medication use through social media campaigns.
  See past issues of our weekly news brief here

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