Practice innovations: delivering medication therapy management services via Videoconference interviews

Abstract

Objective: To describe medication therapy management (MTM) services via videoconferencing.

Design: A descriptive, cross-sectional analysis of an ongoing prospective, randomized-controlled study.

Setting: A secured seven-pharmacy network connected by computers, webcams, telephones, and electronic medical records.

Participants: Patients 18 years of age or older; taking four or more chronic medications; and with diabetes, hypertension, hyperlipidemia, asthma/chronic obstructive pulmonary disease, multiple sclerosis, and/or Parkinson's disease.

Interventions: Chart reviews and videoconferencing interviews to identify medication-related problems (MRP) and provide patient education and recommendations to providers.

Main outcome measures: Patient demographics, identified MRPs, interventions, and patient satisfaction.

Results: During April to July 2010, 43 patients were interviewed (mean age 50.8 ± 11.5 years); of these, 12 patients (27.9%) were older adults, mean age 69.5 ± 5.0 years. Prevalent health conditions were hypertension (31/43, 72%), hyperlipidemia (28/43, 65%), and diabetes (19/43, 44%). A mean number of 3.5 ± 2.3 MRP/patient was identified. Compared with charted numbers, patients significantly under-reported their health conditions (selfreported mean number 4.0 ± 1.6, compared with 6.9 ± 3.3, P < 0.0001) and medications used (self-reported mean number 7.7 ± 3.4, charted number 9.4 ± 2.3, P < 0.005). Providers accepted a mean number of 2.2 ± 1.6 (out of 2.8 ± 1.3) pharmacist-provided recommendations (acceptance rate 78.6%). All patients interviewed agreed or strongly agreed that the MTM interview with pharmacist and the information provided were helpful.

Conclusion: Webcam-enabled videoconferencing allows effective interactions between pharmacists and patients to identify MRP and improve access to MTM services. Provider acceptance of pharmacist-provided recommendations and patient satisfaction with videoconferencing MTM services are high.