title: Impact of telephone medication therapy management on medication and health-related problems, medication adherence, and Medicare Part D drug costs: a 6-month follow up.
abstract: BACKGROUND
  The Medicare Modernization Act of 2003 mandated the provision of medication therapy management (MTM) to eligible Part D beneficiaries to improve medication-related outcomes. As MTM programs evolve, evaluation is necessary to help inform MTM best practices.
  
  
  OBJECTIVE
  The objective of this study was to determine the impact of pharmacist-provided telephone MTM on: (1) medication and health-related problems (MHRPs); (2) medication adherence; and (3) Part D drug costs.
  
  
  METHODS
  This quasi-experimental study included Part D beneficiaries from a Texas health plan. Andersen's Behavioral Model of Health Services Use served as the study framework. MTM utilization was the health behavior. Age, gender, and race were predisposing factors, and number of medications, chronic diseases, and medication regimen complexity were need factors. Outcomes were pre-to-post changes in: (1) MHRPs; (2) medication adherence, using the medication possession ratio (MPR); and (3) total drug costs. Multiple regression was used to analyze group differences while controlling for predisposing and need factors.
  
  
  RESULTS
  At baseline, the intervention (n = 60) and control (n = 60) groups were not statistically different regarding predisposing and need factors, with the exception of gender. The intervention group had significantly (P = 0.009) more men compared with the control group (51.7% vs 28.3%). There were 4.8 (2.7) and 9.2 (2.9) MHRPs identified at baseline and 2.5 (2.0) and 7.9 (3.0) MHRPs remained at the 6-month follow up in the intervention and control groups, respectively. The intervention group (vs control) had significantly more MHRPs resolved (P = 0.0003). There were no significant predictors of change in MPR or total drug costs from baseline to follow up, although total drug costs decreased by $158 in the intervention group compared with a $118 increase in the control group.
  
  
  CONCLUSIONS
  A telephone MTM program resolved significantly more MHRPs compared with a control group, but there were no significant changes in adherence and total drug costs.
authors.affiliation: Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia 23298-0533, USA. lrmoczygemba@vcu.edu
authors.forename: Leticia R
authors.initials: LR
authors.lastname: Moczygemba
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Barner
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Lawson
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Brown
authors.forename: Evelyn R
authors.initials: ER
authors.lastname: Gabrillo
authors.forename: Paul
authors.initials: P
authors.lastname: Godley
authors.forename: Michael
authors.initials: M
authors.lastname: Johnsrud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003157:Community Pharmacy Services / Q000191:economics* / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics*; D016527:Drug Costs; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000191:economics* / Q000706:statistics & numerical data; D055118:Medication Adherence; D054539:Medication Therapy Management / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D008962:Models, Theoretical; D010465:Perception; D015397:Program Evaluation; D012044:Regression Analysis; D013689:Telephone; D013781:Texas; D013997:Time Factors; D014481:United States