The Medication Assessment Program: Comprehensive medication assessments for persons taking multiple medications for chronic diseases

Objective: To describe the development, implementation, and evaluation of a pharmacist patient care program for persons taking multiple medications for chronic diseases. Design: Pilot study. Setting: Services were provided in Michigan within community pharmacies and through home and work-site visits, between October 2004 and September 2006. Participants: 30 pharmacists and 67 patients 18 years of age or older who took four or more medications on a routine basis (three or more times per week). Interventions: The comprehensive medication assessments identified medication- and health-related problems. Pharmacists provided patient education supported by written educational materials and written recommendations for improving drug therapy and overall patient health. Main outcome measures: Patient knowledge regarding medications, diagnoses, and healthy lifestyle practices; types of recommendations made; recommendation acceptance rates; pharmacist assessment of program effects. Results: The program was developed and implemented through a collaborative approach that included pharmacists, colleges of pharmacy, and employers. Pharmacists were supported by various administrative and clinical services offered by the colleges. Three employers adopted the program as a service for their employees, retirees, and dependents. A total of 67 patients received comprehensive medication assessments. Patients tended to be women, tended to be older, and took an average of 12.6 medications. Pharmacists provided 662 recommendations related to drug therapy, healthy lifestyle practices, and the need for medical evaluation. Recommendation acceptance rates, changes in patient knowledge, and pharmacist evaluation of program effects indicated that the program had a positive effect on patient health. Conclusion: A collaborative approach to developing and implementing comprehensive medication assessments was found to be beneficial in improving patient understanding of medications, diagnoses, and healthy lifestyle choices. Written pharmacist recommendations resulted in actions that improved self-monitoring skills and drug therapy appropriateness. College of pharmacy administrative and clinical service support was instrumental in network participation and the provision of care.