The Value of Patient Outreach in Medication Therapy Management

A more hands-on approach to patient care can improve overall outcomes.

A patient outreach model prior to the introduction of a medication therapy management program may improve drug adherence.

A study published in the Journal of Managed Care & Specialty Pharmacy analyzed patients who completed a comprehensive medication review (CMR) before being introduced to a medication therapy management (MTM) programs. The study found higher CMR acceptance rates compared with other models where patients had little to no introduction to MTM programs.

In a retrospective chart analysis, researchers used data obtained from completed CMRs at the University of Florida Medication Therapy Management Communication and Care Center (MTMCCC). The data included health insurance beneficiaries enrolled in 3 health plans during the respective service periods for 2014.

There were 3 models of patient outreach compared in the study. Model 1 was a cold call to patients who received an initial welcome letter from the health plan, and who had never been offered a CMR before being contacted by the MTMCCC.

In model 2, patients were initially offered and subsequently completed a CMR from the health plan before being contacted by the MTMCCC. In the third model, patients received no attempted contact from their health plans before receiving a call from the MTMCC, and then were scheduled to complete the CMR at a future date.

For the study, the CMR completion rate was calculated using the number of completed CMRs and the total number of beneficiaries who were contacted at least once for the provision of a CMR for each of the models by the MTMCCC. This definition is modified slightly from the CMS definition because of limitations in the patient population assignment to the MTMCCC.

The results of the study found that out of the 3 examined health plans, there were 7429 CMRs completed by the MTMCCC, and an attempt to reach 15,715 patients at least once for the provision of a CMR during the service period.

Model 2 demonstrated the highest completion rate at 49.8%, followed by model 1 at 40.5% and Model 4 at 23.8%. The models were found to be statistically significantly different from one another.

Some limitations identified in the study were: the modified calculation used for the CMR completion rate only took into account the patient population assigned to the MTMCCC instead of the entire MTM-eligible population of health plans; the variance among patient populations in each health care plan used in the study, which differed based on MTM eligibility criteria and health plan enrollment; the number of patient contact attempts in each model, as model 2 patients were contacted at least 3 times, while models 1 and 3 only received a single attempt; the challenge of continuity of care for patients with the provision of MTM services from the MTMCCC; and patients potentially avoiding an outreach attempt because of issues with medication adherence.

The findings revealed that patients who were offered, and subsequently completed, CMRs before being contacted for provision of MTM services, had a higher CMR acceptance rate compared with models where patients had little, or no, introduction to MTM programs.

In model 2, the higher rates of acceptance by patients was attributed to familiarity with the service and the expectation of being offered CMRs, researchers stated.

Authors noted that the findings support offering CMR services to patients before they are contacted for the provision of MTM services. Furthermore, a multimodal outreach attempt that includes multiple phone calls and mailings may result in higher overall CMR completion rates.