Implementing a medication management pilot to decrease polypharmacy within a medical home

Purpose: This pilot program was implemented within a medical home focusing on employees and their dependents who are insured by our institution with the goal of 1) decreasing polypharmacy and 2) providing medication therapy management (MTM) for patients on >  12 medications.

Methods: Patients within the medical home who were insured by our institution’s health plan with > 12 medications documented on their medication list within the EMR (electronic medical record) who had an appointment scheduled with their primary care provider between March and April 2012 were identified. The pharmacist contacted these patients prior to their appointments either by phone or in person to provide MTM. Recommendations were communicated to the provider both in person and via the EMR.

Results: Twelve patients met inclusion criteria and received the intervention. There was not a significant reduction in the number of medications following intervention (18 vs 17.2). The pharmacist documented 84 total interventions (7 per patient).  The most common interventions included updating the medication list, counseling patient and providing drug information, and identifying and addressing non-adherence.  Estimated cost savings to the health plan, based on the direct cost of medication, was $950 per month, or $79.10 per patient.

Conclusion: Based on this pilot program, it may be difficult to reduce the number of medications in this patient population; however, providing MTM for these patients can result in several interventions and can decrease medication costs.  The lessons learned from this pilot will be used to refine the implementation of MTM within the medical home at our institution.