title: The effect of medication therapy management service combined with a national PharmaCloud system for polypharmacy patients.
abstract: BACKGROUND
  This study evaluated a medication therapy management service using the Taiwan National Health Insurance Administration's PharmaCloud system in a medical center in Taiwan. The new PharmaCloud System, launched in 2013, links a complete list of prescribed and dispensed medication from different hospitals, clinics, and pharmacies for all insured patients.
  
  
  METHODS
  The study included patients with polypharmacy (≥5 drugs) at a medication therapy management service from March 2013 to March 2014. A structured questionnaire was designed to collect patients' baseline data and record patients' knowledge, attitudes, and practice scores before and after the service intervention. Phone follow-ups for practice and adherence scores on medication use were performed after 3 months.
  
  
  RESULTS
  There were 152 patients recruited in the study. Scores for medication use attitudes and practice significantly increased after the service (attitudes: 40.06 ± 0.26 to 43.07 ± 0.19, p <0.001; practice: 33.42 ± 0.30 to 40.37 ± 0.30, p <0.001). The scores for medication adherence also increased from 3.02 ± 0.07 to 3.92 ± 0.02 (p <0.001).
  
  
  CONCLUSIONS
  The PharmaCloud system facilitates accurate and efficient medication reconciliation for pharmacists in the medication therapy management service. The model improved patients' attitudes and practice of the rational use of medications and adherence with medications. Further studies are warranted to evaluate human resources, executing costs, and the cost-benefit ratio of this medication therapy management service with the PharmaCloud system.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Kuo
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
authors.forename: Kuei-Ju
authors.initials: KJ
authors.lastname: Cheng
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
authors.forename: Wan-Chen
authors.initials: WC
authors.lastname: Shen
authors.affiliation: Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuan-Jen
authors.initials: KJ
authors.lastname: Bai
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Statistics, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chiang
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan. Electronic address: shawn@tmu.edu.tw.
authors.forename: Hsiang-Yin
authors.initials: HY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000067917:Cloud Computing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D008875:Middle Aged; D019338:Polypharmacy; D011446:Prospective Studies; D013624:Taiwan
keywords: Cloud drug profile; KAP model questionnaire; Medication therapy management; PharmaCloud; Polypharmacy