Establishment of a "pharmacy home" model, similar to a medical home model, could better coordinate medication therapies for chronically ill patients with many prescriptions, according to a study published Jan. 10 in the Archives of Internal Medicine.
Provider organizations, according to authors, need to find ways to help patients simplify, synchronize, centralize and organize their medication management. There is a particular need to synchronize medication regimens because "those who make numerous trips to the pharmacy to pick up their medications, or fill prescriptions at different pharmacies, may have difficulty taking their medications as prescribed," the report contends. Report authors also recommend experimenting with programs and technologies to make it easier for patients to better organize their medications.
Researchers at Harvard Medical School and Brigham and Women's Hospital in Boston studied data from pharmacy benefit management firm CVS Caremark. They analyzed claims over a one-year period for 1.83 million heart patients taking statins and 1.48 million taking ACE inhibitors or rennin angiotensen receptor blockers. These are the most widely prescribed medications for treatment of cardiovascular disease.
A view of a particular three-month period demonstrates the need for a pharmacy home. During that three months, patients filled prescriptions for an average of 11 medications in six different drug classes. Ten percent of these patients had 23 or more medications--representing at least 11 different drug classes--with prescriptions written by at least four prescribers and the prescriptions filled at two pharmacies with at least 11 visits to these pharmacies.
The study, "The Implications of Therapeutic Complexity on Adherence to Cardiovascular Medications," is available for purchase at http://archinte.ama-assn.org.
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