Ensuring proper medication therapy isn't easy. As an American College of Clinical Pharmacy notes, obstacles include inadequate therapy, non-adherence, adverse reaction, too high of a dosage, and unnecessary therapy. Comprehensive medication management (CMM) aims to address these and other problems that can stand in the way of patients following a medication regimen that will deliver the most beneficial therapy possible.
Here are eight benefits of comprehensive medication management.
1. Medication Assessment
A medication regimen is like many medical treatments: What works for one patient may not work — or work as well — for another. In fact, some medications that are effective for some patients may have harmful effects on others.
CMM includes an assessment of each individual patient's medications — prescriptions, over-the-counter drugs, vitamins, and supplements — to determine whether they are truly appropriate for the patient and will be the most effective, in conjunction with other medications and treatments, in addressing the underlying medical condition(s) or achieving defined goals. If any medications are found not to be appropriate, they are changed accordingly. Also taken into consideration: A patient's ability to self-administer the medication.
2. Personalized Therapy
CMM also factors in how a patient's health condition, including existing comorbidities; lifestyle; potential barriers to adherence (e.g., health literacy, financial, language; cultural); and other issues may impact medication therapy. Changes are subsequently made to better support the development of a regimen and treatment plan with the best chance for success.
3. Collaborative Care
CMM requires involvement from more than just a clinical pharmacist. It should be a team-driven activity, with insight and recommendations provided by the likes of primary care providers, specialists, nurses, care coordinators, patient navigators, social workers, and others, where and when appropriate. Guidance provided by these individuals can address potential barriers that a pharmacist may not be aware of and further enhance a medication regimen.
4. Patient Engagement
Effective CMM collaboration also strives to actively involve patients in discussions and decisions concerning their medications and treatments. As a Pharmacy Times article notes, "CMM aligns the goal of value-based payment models, which are focused on better outcomes, with the goal of the patient, which is to better understand their complex medication regimen. This proactive, holistic engagement with the patient produces an informed patient who comes to rely on coaching, technology, and coordinated care to actively participate in managing their own health."
5. Ongoing Regimen Review
Unlike medication therapy management (MTM), which typically focuses on a single medication or condition, CMM is not a "one-and-done" activity. Rather, it is an ongoing process that helps ensure a regimen remains appropriate and optimized whenever medications, medical conditions, and/or goals undergo changes or new obstacles to adherence are introduced.
6. Improved Outcomes
The efforts described above ultimately contribute to better clinical outcomes. As a study published in the Journal of Managed Care & Specialty Pharmacy concludes, "Exposure to face-to-face CMM services resulted in improvement of medication adherence. CMM is a powerful practice model that should be encouraged by insurers and health plan administrators to increase rates of medication adherence."
7. Reduced Costs
When executed effectively, CMM can not only improve outcomes, but can also reduce costs for patients and the healthcare system as a whole. As a U.S. Pharmacist report notes, "Researchers at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California San Diego estimate that illness and death resulting from nonoptimized medication therapy costs $528.4 billion annually, which represents 16% of total United States healthcare expenditures in 2016."
Patients save money by purchasing only those medications determined to be appropriate and likely to be most effective. Additional savings are achieved through improved adherence with a regimen and reductions in adverse events, which may require additional treatment. The health system saves by reducing hospital admissions, emergency room visits, and time spent (i.e., wasted) on less productive regimen assessment and adjustment.
8. Increased Satisfaction
Add up these benefits and what do you get: increased patient and physician satisfaction. Patients receive better care and spend less for it, all while feeling like they receive individualized care and are viewed as a valuable and integral participant in their own care. Physicians witness better outcomes; interact with more engaged, satisfied patients; and spend less time on medication-related issues, freeing them up to focus on other critical components of patient care.
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