Featured Research

from universities, journals, and other organizations

Telephone medication therapy management works for some but not all home health patients

Date:
April 9, 2014
Source:
Purdue University
Summary:
Low-risk Medicare patients entering home health care who received medication therapy management by phone were three times less likely to be hospitalized within the next two months, while those at greater risk saw no benefit. The study helped determine which patients benefit most from medication therapy management by phone and a way to identify them through a standardized risk score.

Low-risk Medicare patients entering home health care who received medication therapy management by phone were three times less likely to be hospitalized within the next two months, while those at greater risk saw no benefit, according to a study led by Purdue University.

The study helped determine which patients benefit most from medication therapy management by phone and a way to identify them through a standardized risk score, said Alan Zillich, associate professor of pharmacy practice at Purdue, who led the research.

"Hopefully, this study will help home health care providers target the intervention to those who it will help and improve patient health," he said. "It also tells us there are some patients for whom medication therapy management by phone doesn't work and that we need a different strategy to help these patients."

In medication therapy management a pharmacist evaluates the medications prescribed and how a patient is feeling to identify and resolve issues, including untreated conditions, drug interactions, adverse drug reactions, inappropriate drugs or doses and whether a patient is taking the medications as prescribed.

"We know that medication therapy management (MTM) improves adherence, improves outcomes and improves lives," said Patrick Dunham, CEO of Curant Health, which provided the medication therapy management interventions. "Reducing hospital admissions for the lowest-risk patients in this study by 86 percent is another powerful proof point for the value of MTM and its capability to simultaneously reduce costs and improve care across the health care continuum."

As Medicare may add incentives or penalties for home health care providers based on hospitalization rates, studies of medication management models could influence policy, Zillich said.

"Enhancing the quality of care for patients has always been the goal of health care providers, but the growing costs of Medicare and health care in general have put an even brighter spotlight on strategies to improve patient outcomes and reduce unnecessary costs," he said. "Medication therapy management is considered a valuable tool in this effort, but the best way to deliver it and the patients whom it will most benefit have not been well studied."

Zillich led a team of researchers who collaborated with the home health care organization Amedisys Inc., and pharmacists from Curant Health (formerly HealthStat Rx), who provided the medication therapy management intervention. A paper detailing the research was published in the journal Health Services Research and is available online. Amedisys Inc. funded the research.

"Just as we hypothesized, post-acute care interventions can make a positive impact on preventing issues the elderly may have with their complicated medication requirements: ultimately resulting in lower admissions," said Dr. Michael Fleming, chief medical officer for Amedisys.

The study followed 895 patients from 40 Amedisys home health care centers throughout the United States, with 415 receiving the intervention.

The intervention consisted of an initial phone call by a pharmacy technician to verify active medications, a pharmacist-provided medication regimen review and follow-up phone calls from a pharmacist one week later and as needed for 30 days.

The most common types of medication-related errors are identified soon after transitions of care take place and the first days are the most critical, Zillich said.

"Time is of the essence," he said. "The transition to home-based care -- as with any type of transitions in care -- is a vulnerable time for patients. It involves a switch in health care providers and sometimes a delay in the handoff of medical records. The patients likely have had significant changes or additions to their medications, and sometimes medication-related problems are just starting to appear."

The results showed no overall significant difference in the 60-day probability of hospitalization for those who received medication management therapy by phone versus those who did not. However, when the patients were evaluated based on their risk profiles, those in the lowest-risk group who received the service were three times more likely to remain out of the hospital 60 days after entering into home health care.

A patient's risk of hospitalization was determined through a standard set of nursing assessment items used by all Medicare-certified home health agencies called the "Outcome and Assessment Information Set" or OASIS-C, and the patients were divided into four risk categories.

"Most elderly patients requiring home health care are dealing with multiple chronic conditions and taking multiple medications," Zillich said. "When we say "low-risk" patients in this context, we are talking about the least sick of a very sick group of patients. I'm not sure why they benefited so much from this intervention while the other groups did not. One theory is that they are better able to receive and retain guidance from a pharmacist over the phone and perhaps face-to-face medication therapy management would better help the higher-risk patients."

The team plans to further explore intervention models that would be more effective for the higher-risk Medicare patients entering into home health care.


Story Source:

The above story is based on materials provided by Purdue University. Note: Materials may be edited for content and length.


Journal Reference:

  1. Alan J. Zillich, Margie E. Snyder, Caitlin K. Frail, Julie L. Lewis, Donny Deshotels, Patrick Dunham, Heather A. Jaynes, Jason M. Sutherland. A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients. Health Services Research, 2014; DOI: 10.1111/1475-6773.12176

Cite This Page:

Purdue University. "Telephone medication therapy management works for some but not all home health patients." ScienceDaily. ScienceDaily, 9 April 2014. <www.sciencedaily.com/releases/2014/04/140409143944.htm>.
Purdue University. (2014, April 9). Telephone medication therapy management works for some but not all home health patients. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2014/04/140409143944.htm
Purdue University. "Telephone medication therapy management works for some but not all home health patients." ScienceDaily. www.sciencedaily.com/releases/2014/04/140409143944.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Some Positive Ebola News: Outbreak 'Contained' In Nigeria

Some Positive Ebola News: Outbreak 'Contained' In Nigeria

Newsy (Sep. 30, 2014) The CDC says a new case of Ebola has not been reported in Nigeria for more than 21 days, leading to hopes the outbreak might be nearing its end. Video provided by Newsy
Powered by NewsLook.com
UN Ebola Mission Head: Immediate Action Is Crucial

UN Ebola Mission Head: Immediate Action Is Crucial

AFP (Sep. 30, 2014) The newly appointed head of the United Nations Mission for Ebola Emergency Response (UNMEER), Anthony Banbury, outlines operations to tackle the virus. Duration: 00:39 Video provided by AFP
Powered by NewsLook.com
CDC Confirms First Case of Ebola in US

CDC Confirms First Case of Ebola in US

AP (Sep. 30, 2014) The CDC has confirmed the first diagnosed case of Ebola in the United States. The patient is being treated at a Dallas hospital after traveling earlier this month from Liberia. (Sept. 30) Video provided by AP
Powered by NewsLook.com
New Breast Cancer Drug Extends Lives In Clinical Trial

New Breast Cancer Drug Extends Lives In Clinical Trial

Newsy (Sep. 30, 2014) In a clinical trial, breast cancer patients lived an average of 15 months longer when they received new drug Perjeta along with Herceptin. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins