Outcomes of medication therapy review in a family medicine clinic

Abstract

ObjectiveTo evaluate the effects of pharmacist-conducted medication therapy review (MTR) and intervention on the quality of care of patients in a family medicine clinic. DesignProspective, observational, cohort study. SettingFamily medicine clinic in Minnesota during 2000–2001. PatientsPatients were enrolled in a statewide nonprofit managed care organization; selected patients were seen by a clinical pharmacist. InterventionFollowing MTR, medication-related problems (MRPs) were identified and resolved. Main outcome measuresMRPs identified and resolved, improvement in clinical status, achievement of therapeutic goals, important medication use, and reduction in number of medications. Results92 patients were included in the study, with a total of 203 patient encounters. MRPs were identified in 90% of patients, with a total of 250 identified. Overall status of medical conditions improved in 45% of patients, 46% stayed the same, and 9% declined (P < 0.001). Significant improvement in status was found for hypertension (P = 0.007), dyslipidemia (P = 0.002), and asthma (P = 0.011). Significant improvement was seen for aspirin use for myocardial infarction prevention (50% vs. 93%, P = 0.031) and inhaled steroids for asthma (36% vs. 64%, P = 0.031). The number of medications was reduced from an average of 3.92 to 3.04 (P < 0.001) per patient. ConclusionMTR and intervention by a pharmacist positively affected quality of care in this family medicine clinic.