Medication Optimization in a New Healthcare Era

Published Online:February 05, 2014
In medication use and improving patient outcomes, Susan Cooper, MPH, RPh, senior director, pharmacy services, HealthPartners, says her organization envisions prescription drug optimization going beyond addressing adherence. It seeks to improve the patient experience. Dr Cooper suggests that efficient optimization can underline the triple aim (quality, experience, and affordability) through successful integration approaches, including those that use technology.

Addressing underuse, overuse, and misuse of medications is important because nearly half of the current population do not currently adhere properly to medication. The reasons behind nonadherence vary—Dr Cooper says that it is easy to find thousands of studies that address the reasons, but “The bottom line is that there is no silver bullet or no 1 reason why people aren’t taking their medications.”

Things can go wrong in optimizing medication adherence at many stages, including during diagnosis or treatment (eg, a patient might not arrive for an appointment), with prescriptions (eg, wrong dose or wrong medication), or in continuation and following up (eg, a patient stops taking medication).

In assessing how to focus the optimization of medication, Dr Cooper highlighted the results of a predictive algorithm that uses integrated data sources to identify and stratify high-risk members to targeted interventions based on assessed need. This includes:
  • people who shouldn’t take meds but do
  • people who should take meds but don’t              
  • people who may be taking the wrong medication
The predictive modeling approach includes coding, analysis, interpretation, recommendations, intervention and trials, optimization, and performance analysis. Patient-centered contact technology can be used to identify patients and customize messaging to patients based on their needs. HealthPartners looks at the data and how they can learn from them to promote health behavior.

“Medication therapy management (MTM) pharmacists work to ensure that patients’ medications are appropriate,” she said. “HealthPartners’s MTMs are delivered through existing relationships and integrated within care teams whenever possible.”

Dr Cooper added that MTMs “want to be as integrated as possible.”