Results Background • Community pharmacists often use third-party medication therapy management (MTM) platforms to identify gaps in a patient’s medication regimen (adherence problems, suboptimal drug regimens, cost- saving alternatives, etc.) and recommend targeted interventions to the patient or the prescriber. o These interventions (TIPs) can be completed by a pharmacist, pharmacy resident, or pharmacy student under the supervision of a pharmacist. o With intervention outreach, the pharmacy team member will contact the patient in order to provide support and identify ways to improve the patient’s medication regimen. o In addition to the targeted intervention, the pharmacy team member will provide counseling, facilitate communication with other clinicians, or refer to other pharmacy-based services (PBSs) as appropriate. o Once the targeted intervention is addressed, a claim will be submitted for reimbursement. • According to Took et al., community pharmacies were able to identify and resolve 34 medication- related problems (MRPs) and 81 medication discrepancies in 19 patients, avoiding $92,142 in healthcare costs in only four months.1 o On average, 4.3 discrepancies and 1.8 MRPs per patient o The most common MRP was “underuse of medication”, indicating the need for adherence support in these patients. o This study shows the monetary value of using this platform to help identify MRPs, but the clinical benefit of the program has not yet been established. • Such programs can also be used by pharmacies in an effort to decrease direct and indirect renumeration (DIR) fees. o DIR fees are partially determined by patients’ adherence to oral medications treating hypertension (HTN), hyperlipidemia (HLD), or type 2 diabetes mellitus (T2DM). o As such, this study will evaluate chronic disease control for patients with HTN, HLD, and/or T2DM, by assessing blood pressure (BP), low-density lipoprotein (LDL) levels, and/or hemoglobin A1C (A1C), respectively. Objectives The primary objective of this study is to assess the impact on clinical outcomes of community pharmacists’ use of a third-party MTM platform to identify MRPs. The secondary objectives include adherence rates for patients filling at hospital-based outpatient pharmacies using a PBS and hospitalization due to a complication of HTN, HLD, and/or T2DM. Methods Karen Caye Juco, PharmD; Marlowe Djuric Kachlic, PharmD, BCACP Nazia S. Babul, PharmD, BCACP; Jewel Sophia Younge, PharmD, BCPS Chronic Disease Management by Community Pharmacists Through a Third-Party Medication Therapy Management Platform Limitations Adherence/PDC • PDC was unavailable for prescriptions not filled at an affiliated hospital-based outpatient pharmacy • PDC recorded was the PDC at time of data collection, rather than during the study period Hospitalizations • Could not accurately assess hospitalizations not at the affiliated academic medical center, therefore outside hospitalizations were not included in data collection • Adherence alone cannot prevent all hospitalizations Lab Value Assessment • Changes in lab values cannot be solely attributed to pharmacist interventions • COVID-19 pandemic may have led to delay of lab monitoring for many patients • BP measurements in EMR do not account for potential at-home BP measurements Data Collection • Patient-identifying data was unavailable for some claims in the third-party platform, leading to loss of some data • EMR conversion occurred during the study period, which could have led to unknown data loss • Almost one-third of patients did not have adequate lab values recorded in the EMR for comparison, leading to their exclusion Clinical Decision Making • Assignment of “controlled” versus “uncontrolled” did not account for appropriate deviations in clinical goals (i.e., A1C goal <8% rather than <7% for patients with a history of hypoglycemic events) • Difficult to account for medications used for indications other than BP/LDL/A1C improvement or off- label uses (i.e., sta