Preliminary evaluation of medication therapy management services in assisted living facilities in rural Minnesota.
OBJECTIVE
While pharmacists are providing medication therapy management (MTM) services, few programs have been assessed for outcomes, particularly those in rural areas. The objectives are to: 1) categorize the number and type of drug-therapy problems (DTPs) that were identified by consultant pharmacists in assisted living facilities, 2) assess resident and administrator satisfaction of consultant pharmacist MTM services, and 3) assess the direct costs of providing MTM services and make some preliminary inferences about the program's economic viability.


METHODS
We conducted a cross-sectional, pilot study at 14 assisted living facilities over a 12-month period.


METHODS
14 rural assisted living facilities.


METHODS
Assisted living facility residents.


METHODS
MTM visits were performed by a consultant pharmacist based on the MTM model developed by the American Pharmacists Association.


METHODS
Patient satisfaction, clinical (DTPs), and economic costs.


RESULTS
130 residents were enrolled with a mean age of 86 years, with 77.7% female. Residents were taking an average of 13 medications (range = 1-29), including prescription and nonprescription drugs. Common medical conditions were hypertension (80.0%), hyperlipidemia (37.7%), and diabetes (20.8%). Residents had an average of 9 comorbidities (range = 2-16) and 304 DTPs (mean 2.3 per resident). Residents reported high mean satisfaction levels with the pharmacist and the services provided. Direct costs of the intervention were $20,372.96, which suggests that only modest gains in overall patient health (or a few major avoided adverse events) caused by the intervention are necessary to ensure the program's economic viability.


CONCLUSIONS
Through the use of MTM programs to resolve medication problems, pharmacists can improve patient satisfaction with care among assisted living facility residents.
Scott
David M
DM
Department of Pharmacy Practice, North Dakota State University College of Pharmacy, Nursing, and Allied Sciences, Fargo, North Dakota 58105-5055, USA. david.scott@ndsu.edu
Dewey
Mark W
MW
Johnson
Todd A
TA
Kessler
Matthew L
ML
Friesner
Daniel L
DL
D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000191:economics / Q000458:organization & administration*; D003253:Consultants; D017046:Cost Savings; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000191:economics / Q000458:organization & administration*; D008875:Middle Aged; D008910:Minnesota; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D010865:Pilot Projects; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration
D004364:Pharmaceutical Preparations