title: Implementation and Clinical Outcomes of an Employer-Sponsored, Pharmacist-Provided Medication Therapy Management Program.
abstract: Our objective was to describe the implementation and clinical outcomes of an employer-sponsored, pharmacist-provided medication therapy management (MTM) program for health plan beneficiaries with diabetes mellitus and/or hypertension. We conducted a single-center retrospective medical record review. The setting was a Pharmacy MTM Clinic at a self-insured health system consisting of six hospitals and several ancillary facilities. A total of 161 health plan beneficiaries with diabetes identified during annual wellness screenings for the health plan in 2012 and 225 health plan beneficiaries with diabetes and/or hypertension identified during annual wellness screenings for the health plan in 2013 were referred to the MTM clinic based on specific criteria. In 2012 the health system expanded its existing wellness program by implementing a voluntary diabetes care program for health plan beneficiaries with uncontrolled diabetes (hemoglobin A(1c) [A1C] 7% or higher); a similar program was added for hypertension for the 2013 plan year. All participants' A1C and blood pressure results were tracked from the date of their wellness screening through the end of the plan year. The pharmacists involved had the capability to directly implement drug regimen changes according to hospital protocol or provide recommendations to the physician, as specified by the referring physician. For the 2012-2013 plan year, the mean difference in A1C from baseline to program completion was -0.38% (95% confidence interval [CI] -0.58 to -0.18%, p<0.05). For beneficiaries with a baseline A1C of 7% or higher, the mean difference was -0.69% (95% CI -0.99 to -0.39%, p<0.05). For the 2013-2014 plan year, the mean difference in A1C from baseline to program completion was -0.62% (95% CI -0.81 to -0.44%, p<0.05). In that year, the mean difference in A1C for beneficiaries with A1C 7% or higher was -0.97% (95% CI -1.23 to -0.72%, p<0.05). For those referred for hypertension, a mean difference of -13 mm Hg (95% CI -18.59 to -7.73, p<0.05) from baseline to program completion was seen in systolic blood pressure, and the mean difference in diastolic blood pressure was -7 mm Hg (95% CI -9.92 to -4.04, p<0.05). This study demonstrated that health plan beneficiaries who participated in the employer-sponsored, pharmacist-provided MTM program had significant decreases in A1C and blood pressure.
authors.affiliation: Pharmacy Department, Deaconess Health System, Evansville, Indiana.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Theising
authors.affiliation: Pharmacy Department, Deaconess Health System, Evansville, Indiana.
authors.forename: Traci L
authors.initials: TL
authors.lastname: Fritschle
authors.affiliation: Pharmacy Department, Deaconess Health System, Evansville, Indiana.
authors.forename: Angelina M
authors.initials: AM
authors.lastname: Scholfield
authors.affiliation: Pharmacy Department, Deaconess Health System, Evansville, Indiana.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Hicks
authors.affiliation: Pharmacy Department, Deaconess Health System, Evansville, Indiana.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Schymik
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001794:Blood Pressure / Q000187:drug effects; D048909:Diabetes Complications / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D054539:Medication Therapy Management / Q000458:organization & administration*; D009786:Occupational Health Services / Q000458:organization & administration*; D010593:Pharmaceutical Services / Q000458:organization & administration*; D016730:Program Development; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin
keywords: MTM; ambulatory; blood pressure; diabetes mellitus; employer-sponsored program; hemoglobin A1C; hypertension; medication therapy management