title: Factors affecting demand among older adults for medication therapy management services.
abstract: BACKGROUND
  Medicare Part D took effect in January 2006 with requirements for prescription drug plans to provide medication therapy management (MTM) services to targeted Medicare beneficiaries. The use of Medicare Part D MTM is voluntary by Medicare beneficiaries and no research evidence is available that can inform policy makers of the beneficiary and provider access-level circumstances under which older adults are more likely to demand MTM-like services.
  
  
  OBJECTIVE
  The objective of this study was to describe the effects of the characteristics of older adults and their provider access on the demand for MTM services using data from a unique pre-Medicare Part D program for Medicare-eligible older adults in Iowa.
  
  
  METHODS
  A retrospective cohort study using enrollment, claims, and provider data from the Iowa Priority Prescription Savings (IP) Program. The dependent variable was whether the IP members obtained the MTM service offered by the program. Logistic regression was used to assess whether IP member characteristics and their provider access affected the probability of the IP member to obtain the MTM service.
  
  
  RESULTS
  Demand for the service varied with IP member age, gender, monthly number of drugs taken, monthly prescription drug spending, self-reported health status, having alternative insurance, and seeing multiple physicians. Increased access to pharmacies promoting the service increased IP member demand.
  
  
  CONCLUSIONS
  The demand for MTM-like services varies with the characteristics of older adults and their access to providers that promote the service. Older adults who view themselves as sicker and those with more complex medication regimens appear more likely to demand a service, suggesting that the benefits of the service are either more important or more recognizable to them. However, it appears that older adults require contact with pharmacies that promote MTM services to recognize this value.
authors.affiliation: Department of Pharmaceutical Socioeconomics, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA. john-brooks@uiowa.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Brooks
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Unni
authors.forename: Donald G
authors.initials: DG
authors.lastname: Klepser
authors.forename: Julie M
authors.initials: JM
authors.lastname: Urmie
authors.forename: Karen B
authors.initials: KB
authors.lastname: Farris
authors.forename: William R
authors.initials: WR
authors.lastname: Doucette
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007484:Iowa; D016015:Logistic Models; D008297:Male; D054524:Medicare Part D; D054539:Medication Therapy Management / Q000706:statistics & numerical data*; D010593:Pharmaceutical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States