Outcomes of a Medicare Part D telephone medication therapy management program

Abstract

Objective: To determine the impact of telephone medication therapy management (MTM) on medication- and health-related problems (MHRPs), medication adherence, and total drug costs for Medicare Part D participants.

Design: Quasiexperimental.

Setting: Regional Medicare Part D plan in Texas in 2007.

Participants: Medicare Part D beneficiaries who were MTM eligible.

Intervention: Pharmacist-provided telephone MTM consultation.

Main outcome measures: Change in MHRPs, medication adherence, and total drug costs from baseline to 12-month follow-up.

Results: The intervention (n = 60) and control (n = 60) groups were similar in age (71.2 ± 7.5 years and 73.9 ± 8.0 years [mean ± SD], respectively), number of medications (13.0 ± 3.2 and 13.2 ± 3.4), chronic diseases (6.5 ± 2.3 and 7.0 ± 2.1), and medication regimen complexity index (21.5 ± 7.8 and 22.8 ± 6.9). Men made up 51% of the intervention group and 28% of the control group ( P = 0.009). MHRPs at baseline were 4.8 ± 2.7 in the intervention group and 9.2 ± 2.9 in the control group, with 2.2 ± 2.0 and 7.3 ± 3.0 at the 12-month follow-up. MHRPs decreased ( P = 0.01) in the intervention group. We found no predictors of change in medication adherence. Drug costs decreased by $682 ± 2,141 in the intervention group and increased by $119 ± 1,763 in the control group. A t test indicated that the cost difference was significant ( P = 0.03), but the adjusted regression analysis did not identify any significant predictors.

Conclusion: A telephone MTM program reduced MHRPs. Unadjusted cost comparisons showed cost savings in the intervention group. Future research should focus on understanding how telephone MTM affects medication adherence.