Chronic conditions are one of the fastest-growing health concerns facing the United States today. In 2020, the number of Americans 50 years or older with at least one chronic disease was 71.52 million, a number that is projected to increase by 99.5% (to the tune of 142.66 million Americans) by the year 2050.
This alarming trend makes a few things abundantly clear:
1. Chronic disease is an epidemic of epic proportionsNow more than ever, our healthcare system must shift to curtail these conditions and proactively prevent them before they spiral further out of control.
Unlike other parts of the healthcare system which aim to reactively treat illnesses or injuries when they happen, chronic condition management must be a long-term strategy focused on proactive care rather than reactive treatment.
One factor that makes chronic conditions so difficult for health plans to tackle is that proper management often requires behavioral changes from members who have previously been educated about their conditions and empowered with the information they need to take an active role in their health. Take healthy behaviors such as exercise, smoking cessation, and eating a balanced diet. These behaviors can dramatically reduce instances of chronic conditions including obesity, diabetes, high cholesterol, and more. What’s critical, though, is that health plan members understand the why behind these behavior modifications and feel motivated to make a change. If a member is simply told to take a specific action such as quitting smoking, they’re less likely than if they’re given information about the downstream implications to their health and wellbeing. Creating these types of lasting lifestyle changes can help health plan members stay healthier in the long term and reduce their likelihood of chronic conditions.
An equally important factor in preventing and managing chronic conditions is maintaining a strong rate of medication adherence. It’s no surprise that medications are an integral component to chronic condition management, but what some patients fail to realize is that proper adherence is integral for their medications to work as intended. Simply put, medications don’t do their job if they aren’t taken properly. That’s why creating a long-term focus on medication adherence is needed to proactively manage chronic disease. The perfect vehicle for such a medication adherence program is through recurrent medication reviews delivered by pharmacists.
Medication therapy management (MTM) is one of the best ways to both create healthy behaviors and continuously monitor and optimize medication usage.
As one of the top drivers of cost in our healthcare system, hospital visits, and emergency room utilization in particular, should be avoided to lower healthcare costs overall. Fortunately, studies show that medication therapy management can reduce unnecessary hospital visits. In fact, one study showed that MTM consultations resulted in 12% fewer hospital admissions per 1,000 members.
Because MTM consultations take place on a recurring basis, they provide excellent opportunities for pharmacists to check in with members and make them active participants in their own health. During these consultations, pharmacists can also provide valuable counseling about proactive treatments such as vaccinations, to encourage further healthy behaviors throughout the year.
When health plan members have more information, they’re able to make better decisions. By speaking with pharmacists, healthcare’s top medication experts, health plan members get an unrivaled level of education about their conditions and medication regimens. When armed with this information, they’re better equipped to make the right choices, such as staying adherent to their prescriptions.
During an MTM consultation, pharmacists can assess members’ full medication regimens and identify gaps or combinations in drugs that could be causing unfavorable side effects. Through this process, issues are identified and can be surfaced to the prescribing provider for correction.
Adverse drug events are defined as “harm experienced by a patient as a result of exposure to a medication”. These often take place in the form of high-risk medications that can cause serious health issues if not dosed or administered properly, or if a patient has a negative reaction to a medication, termed an adverse drug reaction (ADR). The sad truth is that these reactions are estimated to number in the millions, causing more than 106,000 deaths annually, making them the fourth leading cause of death in the US. Fortunately, through regular MTM consultations, patients’ reactions to medications can be monitored and if necessary, proactive interventions can prevent serious health issues before they ever occur.
While we as a healthcare system can collectively create programs and interventions to help patients live healthier lives, patients’ health is ultimately in their own hands. Patients are responsible for choosing whether to take their medications as prescribed, modifying their behaviors and routines to become healthier, and seeking appropriate health services when they need them.
The knowledge and tools to do exactly that can be provided to patients through pharmacist-led medication therapy management programs. But to create a high-performing MTM program that meets health plan goals, it’s critical to ensure you’re using the appropriate clinicians. Just as you’d want a cardiologist to counsel on heart problems or an oncologist to manage cancer treatment, pharmacists are our healthcare system’s medication specialists.
During a medication therapy management consultation, pharmacists assess a health plan member’s entire medication regimen, including prescription drugs, over-the-counter medications, supplements, and even herbal remedies. It’s through this comprehensive medication review that pharmacists are able to get a holistic view of what a member is taking and how it could potentially create a negative impact on their health. Pharmacists also provide helpful coaching and goal setting during MTM consultations, allowing patients to be active in improving the management of their chronic conditions. From a simple goal of taking a walk once a day to lifestyle modifications such as a diet overhaul, pharmacists give members the tools they need to succeed.
Aspen RxHealth partners with health plans to create the innovative MTM programs that their members deserve. Whether you’re searching for a new MTM platform for your in-house team, or need a fully delegated MTM partner, Aspen RxHealth has a solution to fit your needs. See all the ways in which we can help you succeed here.