UF MTM call center aims to improve medication adherence, star ratings

Abstract

Medication adherence is a complicated problem for which there is not a one-size-fits-all solution. Barriers to adherence are unique for every patient and can vary from medication to medication. Improving medication adherence requires a deeper understanding of critical questions. Are patient-specific interventions more effective than basic reminders to patients? Which interventions are most effective? Medication adherence is a complicated problem for which there is not a one-size-fits-all solution. Barriers to adherence are unique for every patient and can vary from medication to medication. Improving medication adherence requires a deeper understanding of critical questions. Are patient-specific interventions more effective than basic reminders to patients? Which interventions are most effective? These are questions being asked in receive quality bonus payments and new research currently under way at the University of Florida Medication Therapy Management Communication and Care Center (UF MTMCCC). The Pharmaceutical Research and Manufacturers of America Foundation recently awarded a 1-year, $50,000 grant to Anna Hall, PharmD, to conduct further analysis of the outcomes associated with UF MTMCCC's telephonic adherence intervention program. The randomized, controlled trial will evaluate the impact of using predictive analytics and a telephonic program that aims to improve medication adherence and CMS star ratings for a Medicare Advantage prescription drug plan (MAPD). CMS star ratings are a set of clinical measures designed to monitor quality of care, including adherence for diabetes, hypertension, and cholesterol medications. MAPD plans that score well on star ratings receive quality bonus payments and other benefits. "Learning which interventions are most effective can be applied widely," Hall told Pharmacy Today. She is a Clinical Assistant Professor at the UF College of Pharmacy and the Assistant Director of the UF MTMCCC. "Community pharmacists anywhere can help patients improve adherence. Pharmacists can work with patients to identify each patient's barriers to adherence to make sure they get the right intervention to the right patient." In collaboration with WellCare Health Plan, Inc., and its predictive analytics partner RxAnte, the UF MTMCCC developed a program specifically to improve CMS star ratings related to adherence. Originally, the program focused on reminder calls to patients to encourage them to take their medications as prescribed. The expanded UF MTMCCC adherence program includes a validated assessment of patient-reported medication use, delivered by phone, to identify patient-specific barriers to adherence. Patients' barriers to adherence identified by UF MTMCCC during the program included forgetfulness, not understanding why a medication is needed, not feeling like a medication is helping, cost, running out of refills, and adverse effects. Based on this assessment, the UF MT- MCCC offers interventions tailored for individual patients and provides ongoing follow-up support. These interventions include disease state and medication education, adverse drug effect assessment and pharmacist outreach, cognitive impairment assessment, reminder tools, refill synchronization, financial assistance programs, and refill convenience methods. "As the literature suggests, improving medication adherence will likely require tailored interventions and multiple strategies," Hall said. "To perform well on the adherence ratings, plans will need to implement a variety of strategies to optimize impact. The key is knowing which members to target through the use of predictive analytics, and delivering interventions tailored to patient-specific barriers." Hall expects the findings from the study to illustrate that the use of predictive analytics to provide guided targeting, combined with an assessment of barriers and patient-specific interventions, is an effective method for improving CMS star ratings related to adherence. "We are driven by the fact that even prior to expanding our adherence services, we know that our outreach to patients has made an impact on adherence and plan ratings," Hall said. "We are eager to see if our expanded services will have a larger impact and can contribute to national efforts encouraging patients to remain adherent to critical medications."