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In 2003, AccessCare launched a successful polypharmacy review service involving consultant pharmacists to nursing homes throughout the state who work with the patient's physician. The service has since been expanded to assisted living facilities.
However, an unknown number of ambulatory patients have complex drug therapy regimens that may be suboptimal and/or unnecessarily costly. For example, the number of drug-drug interactions increases with the number of drugs being taken.
Because local care managers and physicians often ask for the assistance of a pharmacist in reviewing drug regimens, AccessCare has launched a pilot referral program in four counties. A consultant pharmacist who practices in the locale of the each clinic has been made available to make office visits to conduct medication reviews.
Pharmacists receive referrals for drug regimen reviews from physicians practicing at the clinic, nurse case managers affiliated with the clinic, or AccessCare's screening of Medicaid claims for high or complex drug use. The pharmacist conducts a comprehensive drug therapy review based on the patient's available drug profile. If recommended by the physician, the review may be supplemented with a "brown bag" review conducted as part of a one-on-one session with the patient. In the course of conducting the drug therapy review, the pharmacist may obtain additional data about the patient's condition. The pharmacist then identifies potential drug therapy problems, recommends changes to remedy the problem, and communicates these recommendations to the patient's physician. No action is taken without the physician's prior consent.
AccessCare is tracking the number of patients seen, recommendations made for changes in therapy, changes that were accepted and actually occurred, and impact on use and cost of prescription drugs. Results will be compared to a random sample of patients in geographic areas without the service.
Please complete and print a pharmacy referral form. Once completed please fax to 919-468-8573, Attn: Stephanie Christofferson, Pharm.D.
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