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* Department of Communication
* School of Pharmacy and Pharmaceutical Sciences

October 28, 2008

Study reveals obstacles that keep pharmacists from aiding patients

WEST LAFAYETTE, Ind. - Pharmacists, who are federally required to provide educational services to some Medicare patients, are facing a number of obstacles that keep them from helping chronically ill patients, according to a new Purdue University study.

"Our team identified nine barriers that affect how key educational services are administered to patients, many of whom are chronically ill," says Melanie Morgan, an associate professor of communication and one of the two faculty members who oversaw the study. "Lack of time, education and privacy, as well as insufficient reimbursement and problems communicating with prescribing physicians, were all obstacles in themselves. But, the lack of management support was the most prevalent problem reported by pharmacists in this study."

Since 2003 pharmacists have been required to provide medication therapy management services for millions of Medicare patients. These patients, who qualify Medicare's Part D: Prescription Drug Plan, have multiple chronic diseases, such as diabetes and heart disease; have been prescribed several medications; and are paying at least $4,000 in out-of-pocket medication expenses per year, says Christy Nash, an assistant clinical professor of pharmacy practice and associate director of experiential learning.

Medication therapy management services are individual counseling sessions between the pharmacist and patient, and they have been shown to improve how patients manage chronic diseases and avoid potential drug interactions, which are two of the costliest problems in health care, Nash says.

The results of the Purdue study are published in a three-part series that concludes in this month's International Journal of Pharmaceutical Compounding. In addition to Morgan and Nash, the research team was composed of graduate students Jeremy P. Fyke, Robert N. Yale, Corinne Corbett and Natalie Litera. More than 80 pharmacists in Indiana were surveyed, and six in-depth interviews were conducted about pharmacist attitudes and practices surrounding medication therapy management services.

Other findings showed a lack of standardization and unclear definition of medication therapy management services in the pharmacy industry. In addition, nearly 30 percent of the respondents reported receiving no training to prepare them to counsel patients on managing their medications.

"The mission of pharmacists is not limited to dispensing medications. We also strive to educate and help patients improve," Nash says. "Many pharmacists want to see these educational services improved and expanded so we can improve patients' quality of life issues, but these roadblocks need to be addressed first.

"Our recommendations for improvement are as simple as managed care providers simplifying documentation and administrative requirements for these services. We also recommend providing access to standardized medication therapy management training, and we encourage pharmacists, physicians and insurance companies to take an active role in promoting these educational services to patients."

This study will be expanded to survey pharmacists in Arizona, Arkansas, Iowa, Kansas, Louisiana and Maryland. This study was supported by the College of Liberal Arts' Department of Communication, and its findings also have been reported in the Indiana Pharmacist.

Writer: Amy Patterson Neubert, (765) 494-9723, apatterson@purdue.edu

Sources: Melanie Morgan, (765) 494-3305, morgan3@purdue.edu

Christy Nash, (502) 645-5566, Christy@pharmacy.purdue.edu

Purdue News Service: (765) 494-2096; purduenews@purdue.edu


ABSTRACT

Medication Therapy Management: Barriers and Recommendations to Overcome Barriers

Jeremy P. Fyke, Robert N. Yale, Corinne Corbett, Natalie Litera

As a required service of the Medicare Modernization Act of 2003, medication therapy management services must be offered by all Part D prescription drug-plan sponsors in order to improve overall knowledge of medication usage for targeted patients. Those targeted patients include patients who have multiple chronic diseases, have been prescribed several covered Part D medications, and are paying at least $4,000 for their medication each year. This article discusses some of the barriers and recommendations to overcome such barriers encountered by Indiana pharmacists.


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