Medication Monitoring: Exploring a New Model for Community Pharmacists

As third-party payer reimbursement decreases, community pharmacies aim to increase prescription volume to compensate. Consequently, the role of the community pharmacist has become 68% dispensing and some organizations have been forced to cut medication monitoring resources. A recent study indicates that continuous medication monitoring (CoMM) could serve as a valuable tool for community pharmacists, shifting the focus from dispensing to improving patient outcomes and medication use.

In contrast to other strategies, CoMM concentrates on preventing, identifying, resolving, and documenting drug therapy problems for all patients. While approaches like medication therapy management use algorithms and claims data to determine eligible patients, CoMM takes advantage of a pharmacist’s ability to identify patients based on factors like poor cognitive function or risky living situations.

Medications of interest in this study were angiotensin converting enzyme inhibitors/angiotensin II receptor blockers, statins, diabetes medications, warfarin, opioids, and selective serotonin reuptake inhibitors. The researchers note these are medications for which they receive adherence data, or have safety concerns.

The researchers conducted a retrospective review of pharmacy dispensing and clinical records at an independent community pharmacy in the Midwest. The study examined records of 2481 patients who filled at least 1 prescription and received at least 1 CoMM intervention over the course of a year.

Pharmacists delivered an average of 6.8 interventions to each patient and a total of nearly 17,000 interventions. Benefits were not limited to high-risk individuals, as 1.2 drug therapy problems on average were discovered in patients taking fewer than 8 medications.

These findings do not apply universally to community pharmacies. The study pharmacy had a robot to automate portions of the dispensing process and employed additional pharmacists to accommodate for increased time spent on CoMM.

Three things are necessary for the CoMM model's success:

• Third-party payers must provide reimbursement for these services.
• Dispensing software must incorporate the ability to document interventions.
• Pharmacists must be educated on how to identify problems quickly, prioritize them, intervene, and document actions taken.

Further studies on the widespread use of the CoMM model are necessary.

The current study was published in Research in Social and Administrative Pharmacy.

Reference

Goedken AM, Butler CM, McDonough RP, Deninger MJ, Doucette WR. Continuous Medication Monitoring (CoMM): A foundational model to support the clinical work of community pharmacists. Res Social Adm Pharm. 2017; pii: S1551-7411(16)30592-7. doi: 10.1016/j.sapharm.2016.12.008. [Epub ahead of print]