Comprehensive Medication Management*
With growing numbers of patients living with chronic diseases, medication optimization has become increasingly important in reducing disease burden, improving health outcomes, decreasing health care costs, and improving quality of life.
Why is this important?
Medications are involved in 80% of all treatment plans and affect almost every aspect of a patient’s life.1 Nonoptimized medication therapy and the misuse of medications costs the United States over $528 billion annually, roughly 16% of total health care dollars spent.2 According to the World Health Organization, adherence to therapy for chronic diseases in developed countries averages 50%, and poor adherence to therapies results in poor health outcomes and increased health care costs.3
Although poor adherence is commonly cited as the primary problem with patients’ medication use, growing evidence shows that inadequate therapy - defined as dose too low, different or additional drug needed, or wrong drug - is the leading cause of treatment failures and incomplete achievement of clinical goals.4,5 When data from 19 distinct medication management service practices, involving 11,804 patients older than 65 years and 21,213 documented encounters were aggregated, more than half of the problems encountered were due to inadequate therapy.4
Other causes include:
- Care delivery fragmentation
- Complexity of medication regimens
- Medication side effects
- Insufficient comprehension of medication instructions and competing demands on patients’ time and resources
There is significant evidence that team-based and patient-centered comprehensive medication management results in optimized medication use and improved outcomes.
How will these tools help?
- Effectively identify and resolve medication therapy problems
- Improve health outcomes and achieve patient-centered goals
- Improve patient engagement and satisfaction
- Improve provider satisfaction and work life
- Decrease rate of all-cause hospitalization
- Decrease rate of medication-related hospitalization
- Reduce total and medication-related hospitalization costs
- Reduce total costs of care (per capita costs)
- Slone Epidemiology Center at Boston University. Patterns of Medication Use in the United States 2006: A Report from the Slone Survey. http://www.bu.edu/slone/files/2012/11/SloneSurveyReport2006.pdf. Accessed July 13, 2020.
- Watanabe JH, McInnis T, and Hirsch. Cost of Prescription Drug-Related Morbidity and Mortality. Annals of Pharmacotherapy. 2018;52(9):829-837.
- Patient-Centered Primary Care Collaborative (PCPCC). The patient-centered medical home: integrating comprehensive medication management to optimize patient outcomes resource guide, 2nd ed. Washington, DC: PCPCC, 2012. Available from www.pcpcc.org/sites/default/files/media/medmanagement.pdf. Accessed July 13, 2020.
- Strand, L. Written communication. October 4, 2013.
- Ramalho de Oliveira D, Brummel A, and Miller D. Medication Therapy Management: 10 years of experience in a large integrated health care system. Journal of Managed Care Pharmacy. 2010;16(3):185-195.
- Physician Assistants
- Nurse Practitioners
- Registered Nurses
- Medical Assistants
- Practice Managers
- Assess your practice’s commitment to prioritizing medication optimization for all patients.
- Identify ways to implement comprehensive medication management strategies that are team-based.
- Develop an ongoing process to comprehensively review patients’ medication lists, assessing each medication’s indication, effectiveness, and safety, and evaluating patient adherence.
- Engage health care team members, patients, and caregivers to ensure medication regimens are aligned with patient-centered goals.
- Ensure that patient- and caregiver-centered medication-related education is provided.
- Collaborate with pharmacists throughout the medication management process to capitalize on their medication expertise and medication management experience.
- Co-create a care plan, engaging the patient in self-monitoring and providing follow-up clinical evaluation.
Practice Advisor Content Manager
Margo Williams, MHA, CMPE Manager Practice Support, American College of Physicians
Lori T. Armistead, MA, PharmD, Senior Research Associate, Center for Medication Optimization, UNC Eshelman School of Pharmacy
Kaitlyn M. Bader, PharmD, MTM Pharmacist, M Health Fairview
Marcia L. Buck, PharmD, Director, Clinical Practice Advancement, American College of Clinical Pharmacists
Katherine Pham, Pharm.D, BCPPS, Director, Policy and Professional Affairs, American College of Clinical Pharmacy
ACP Staff Editors
Disha Patel, Analyst Practice Support, American College of Physicians
All individuals listed (manager, contributors, editors) have nothing to disclose.
Continuing Medical Education
The American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians.
The ACP designates this CME activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 20 practice assessment MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credit claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
This module offers CME and practice assessment MOC points, as well as verification of attendance. Credit is divided into two stages. After taking the ACP Practice Biopsy, reading the background material and case study, reviewing the resources, and creating a Practice Improvement Action Plan, users may submit for up to 10 credits and points. To receive the remaining 10 credits and points you must implement measurable changes in one or more targeted areas, and come back after 30 days and take a Follow-up Biopsy before CME/MOC can be claimed.
Once you have completed each stage, you will be provided instructions on how to claim CME and MOC credit or download a certificate of attendance.
Original Release Date: October 5, 2020
Expiration Date: October 5, 2023
To earn CME credits, you must attest after completion of the second module biopsy that you have:
- Participated in the completion of the ACP Practice Biopsy
- Participated in the review of the ACP Practice Biopsy result
- Participated in identifying an action plan to improve our practice
- Participated in the implementation of the plan
- Participated in the follow up ACP Practice Biopsy to measure improvement
When you have done so, follow the on-screen instructions to complete and submit the submission form.
- 20.00 ABIM MOC
- 20.00 AMA PRA Category 1 Credit™
- 1.00 Attendance