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GERIATRICS

Economic Impact of a Pharmacy Resident in an Assisted Living Facility–Based Medication Therapy Management Program

at time of writing, Pharmacy Practice Resident, North Dakota State University/Lake Region Healthcare Corporation, Fargo, ND; now, Clinical Pharmacist, St. Cloud Hospital, St. Cloud, MN

Donald R Miller, PharmD FASHP

Professor and Chair, Department of Pharmacy Practice, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University, Fargo, ND

Todd Johnson, PharmD

Associate Professor, Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN; CEO, Consultant Pharmacists Incorporated, Fergus Falls, MN

Mark Dewey, PharmD CGP FASCP

Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University, Fargo, ND

Reprints: Dr. Maack, St. Cloud Hospital, Department of Pharmacy, 1406 6th Ave. North, St. Cloud, MN 56303, fax 320/656-7048, brodym{at}centracare.com

BACKGROUND: Pharmacists now have the opportunity to be reimbursed for providing medication therapy management (MTM) services. With 5% of the elderly population living in senior housing such as assisted living facilities, MTM programs need to be evaluated in this setting.

OBJECTIVE: To evaluate the economic impact of a postgraduate year 1 (PGY1) pharmacy practice resident's interventions while performing MTM in an assisted living facility.

METHODS: We conducted a prospective, evaluative study at an assisted living facility over 184 days. Patients included in the study were aged 57–100 years. MTM visits were performed by the PGY1 resident, based on the American Pharmacists Association consensus definition of the model of MTM services. The pharmacy resident prospectively collected data, including interventions made and patient demographics. Drug therapy recommendations were categorized and assessed for cost savings and acceptance by a primary care provider.

RESULTS: Fifty-three patients were enrolled in the study (mean age 85.3 y). Patients were taking an average of 12 medications (prescription and nonprescription). The pharmacy resident made 125 recommendations to primary care providers; 72 of those were addressed and 90.3% of addressed recommendations were accepted. The largest category to elicit drug therapy recommendations was dose appropriateness. Of the 72 addressed recommendations, 17 (23.6%) resulted in direct cost savings totaling $3774. Costs that accrued as a result of drug therapy recommendations totaled $693. The resultant net cost-benefit was $1550, with a benefit-to-cost ratio of 1.7 and a return on investment of 70%.

CONCLUSIONS: Our study demonstrates the positive value that a PGY1 pharmacy resident has on an assisted living–based MTM program, with respect to a positive drug-related cost-benefit and drug therapy recommendation acceptance.

Key Words: assisted living facility, economic impact, medication therapy management, pharmacy resident

Published Online, October 21, 2008. www.theannals.com, DOI 10.1345/aph.1L191