Category: Federal Forum Posters
Purpose: Suboptimal patient outcomes and increased healthcare costs due to medication noncompliance are recurring problems. A recent study by Gutierrez et al. demonstrated increased medication adherence in Veterans with psychiatric illnesses at the Denver VA Medical Center when medications were supplied in blister packs; however, cost outcomes were not evaluated. The purpose of this study is to assess medication adherence in addition to cost outcomes for Veterans enrolled in MHICM at PVAMC who are receiving multi-blister medication packaging through the outpatient pharmacy. Demonstrating improved medication adherence and cost effectiveness in this patient population would support further development of medication blister-packaging services.
Methods: The study population will include Veterans who are enrolled in the multi-blister packaging program and MHICM. Seven-day SureMed® multi-blister packaging is utilized to organize medications based on morning, noon, evening, and bedtime doses. In most cases, a 28-day supply is dispensed.
Adherence will be assessed for eight months before and after enrollment. A multi-measure approach will be used to estimate adherence due to lack of a gold standard. Adherence will be measured subjectively through the clinician rated Brief Adherence Rating Scale (BARS) and patient rated Self-Efficacy for Appropriate Medication Use Scale (SEAMS). Medication Possession Ratio (MPR), proportion of days covered, and distance from perfect adherence will be used to objectively measure adherence.
Cost outcomes will be assessed for one year before and after enrollment. Maintenance medication costs one year prior to enrollment will be evaluated through each Veteran’s dispensing history. Maintenance medications will be defined as prescriptions used to treat chronic illness. Post enrollment medication costs will be predicted for each Veteran with the assumption maintenance medications do not change from time of enrollment. In addition to product cost, full time employment will be evaluated for pharmacy and MHICM staff to compare workload before and after the multi-blister packaging program.
Results: Not applicable
Conclusion: Not applicable
Ashley Chace– Pharm.D. Candidate 2018, University of New England College of Pharmacy, Sandwich, MA