Established in 2013, the Institute of Therapeutic Innovations and Outcomes (ITIO) Medication Management Program (MMP) is home to pharmacists, student pharmacists and certified pharmacy technicians who provide telehealth medication management services designed to reduce health care costs and improve medication use.
Medication use is becoming more complex - patients are often dealing with a number of chronic conditions managed by several providers. Numerous medications may often be filled at multiple pharmacies and MMP helps millions of patients manage this complex situation through personal coaching from medication experts.
MMP services are designed to optimize health outcomes for individual patients and empower patients to take control of their health. This is done by:
- Educating patients on chronic disease states and helping them to get the most benefit from their medications.
- Intervening with patients and providers regarding medication adherence, safety concerns, effectiveness of treatment and medication costs.
- Medication Reviews – Comprehensive and targeted medication evaluations to identify and reduce drug-drug interactions, drug-disease interactions, potentially harmful medications, medication nonadherence and increase the prescribing of evidence-based medicines for chronic diseases.
- Long Term Care Outreach – Through interprofessional collaboration, MMP reaches out to long term care centers to impact patients who are unable to complete a medication review on their own.
- Multilingual Services – Our diverse staff communicate with patients who speak a variety of languages. Translation services are also available so that all patients can receive our care.
- Paid Pharmacy Internships – Student pharmacists enrolled in a PharmD program are eligible for paid pharmacy internships.
- Student Advisory Board – Empowers our pharmacy students to develop essential leadership skills. The Student Advisory Board consists of a representative from each intern class and undergraduate class. They serve as the voice of their class and meet with our leadership team monthly.
- Clinical Rotation Site – MMP serves as a clinical rotation site for The Ohio State University College of Pharmacy. Student pharmacists strengthen their clinical skills during their advanced rotations with a focus on ambulatory care pharmacy.
- Fellowship Program – MMP is home to a fellowship in managed care/medication therapy management. The fellowship focuses on development of research skills, with additional experiences in teaching and practice.
According to the Joint Commission of Pharmacy Practitioners, “Medication Management Services are a spectrum of patient-centered, pharmacist-provided, collaborative services that focus on medication appropriateness, effectiveness, safety, and adherence with the goal of improving health outcomes.”
MMS services improve patient outcomes while reducing overall health care costs. At ITIO-MMP, the services are completed in the form of a Comprehensive Medication Review (CMR) or a Targeted Medication Review (TMR). The call to complete the CMR typically takes 20-30 minutes in total and allows one-on-one time with a clinical pharmacy staff member.
- Utilizes evidence-based treatment guidelines to ensure patients are receiving the correct medications for their disease state.
- Provides disease state management by educating patients about their disease, educating patients about preventative measures to slow the progression of their disease and/or avoid complications from their disease, and evaluate treatment based on lab results or test results such as fasting blood glucose, hemoglobin A1C, blood pressure and lipids.
- Identifies drug-drug interactions and drug-disease state interactions with appropriate follow-up.
- Decreases costs for patients from consultation with a pharmacist with resultant increases in patient medication adherence and improved overall health outcomes.
- Educates patients about the proper timing and administration of their medications.
- Assists patients in formulary conversions. This includes talking with the patient regarding previous therapy to assess if a formulary conversion to an alternative medication or choice of another dosing schedule is preferred.
- Performs comprehensive medication reviews to look for unnecessary and duplicate therapy. If these are noticed, the pharmacist communicates this to the prescribing practitioner in order to discontinue unneeded medications.
- Decreases expenditures on morbidity and mortality from drug-related problems by better managing disease states and properly identifying drug-related problems.
- When clinically appropriate, works directly with patients and prescribing practitioners to titrate medications to maximum doses before adding on new medications in order to minimize the number of medications taken by each patient.
A strong emphasis is given to the development of independent and collaborative patient-centered and population-based research skills in areas including assessment of clinical practice guidelines, formulary management and medication management services to optimize medication efficacy, safety, adherence, patient satisfaction and costs.
Original Research Examining the Need for Medication Management Services
- Silva Almodóvar A, Nahata MC. High opioid doses, naloxone, and central nervous system active medications received by Medicare-enrolled adults. J Am Geriatr Soc. 2023;71(1):98-108. doi:10.1111/jgs.18102
- Silva Almodóvar A, Hackim E, Wolk H, Nahata MC. Potentially Inappropriately Prescribed Medications Among Medicare Medication Therapy Management Eligible Patients with Chronic Kidney Disease: an Observational Analysis. J Gen Intern Med. 2021;36(8):2346-2352.
- Silva Almodóvar A, Nahata MC. Potentially Harmful Medication Use Among Medicare Patients with Heart Failure. Am J Cardiovasc Drugs. 2020;20(6):603-610. doi:10.1007/s40256-020-00396-z
- Silva Almodóvar, A, Nahata MC. Potentially Unsafe Chronic Medication Use Among Older Adult Chronic Opioid Users. Pharmacotherapy. 2019 Feb;39(2):140-9.
- Silva Almodóvar A, Clevenger J, Nahata MC. Effects of adjuvant medications on A1C, body mass index, and insulin requirements among patients with type 1 diabetes. Pharmacy. 2022;10(4). doi: 10.3390/pharmacy10040097
Original Research Examining Outcomes of Medication Management Services
- Silva Almodóvar A, Ross E, Nahata MC, Bingham JM. Social needs of dual-enrolled Medicare-Medicaid patients with medication nonadherence in a telehealth medication therapy management program. J Manag Care Spec Pharm. 2023;29(2):210-215. doi:10.18553/jmcp.2023.29.2.210
- Silva Almodovar A. Malfara A. Nahata MC. Impact of automated targeted medication review electronic alerts to reduce potentially inappropriate medication prescribing among medicare enrolled patients with dementia. Ann Pharmacother. 2020:1060028020915790. doi: 10.1177/1060028020915790 [doi].
- Bingham J, Silva-Almodóvar A, Lee H, et al. The role of the pharmacist in mental health: An investigation of the impact of pharmacist-led interventions on psychotropic medication adherence in patients with diabetes. J Am Pharm Assoc (2003). 2020;60(4):e58-e63. doi:10.1016/j.japh.2020.01.009
- Silva Almodóvar A, Smith K, Nahata MC. Relationship between patient characteristics and number of phone calls to complete a telehealth comprehensive medication review: A cross-sectional analysis [published online ahead of print, 2020 Jul 18]. J Am Pharm Assoc (2003). 2020;S1544-3191(20)30285-5. doi:10.1016/j.japh.2020.06.019
- Silva Almodóvar, A. Nahata MC. Associations between Chronic Disease, Polypharmacy, and Medication-Related Problems Among Medicare Beneficiaries. J Manag Care Spec Pharm. 2019 May;25(5):573-7.
- Silva Almodovar, A, Axon DR, Coleman AM, Warholak T, Nahata MC. The Effect of Plan Type and Comprehensive Medication Reviews on High-Risk Medication Use. J Manag Care Spec Pharm. 2018 May;24(5):416-22.
Role of Student Pharmacist Development within a Medication Management Program
- Silva Almodóvar, A, Kevin Chang HC, Matsunami M, Coleman A, Nahata MC. Confidence in skills applied to patient care among PharmD students in telehealth medication management programs versus other settings. Curr Pharm Teach Learn. 2018 May;10(5):558-65.
- Bingham JM, Silva Almodovar A, Taylor AM, Axon DR, Nahata MC, Leal S, Warholak T, Scovis N. A Research Partnership to Enhance Postgraduate Pharmacy Residency Training Outcomes. Pharmacy. 2020; 8(3):134.
- Badowski M. Bente JA. Davis EM. Isaacs D. Lewis L. Martello JL. Pitlick M. Silva-Almodovar A. Stadler S, Sutton E. Belk M. Tovey A. Kane-Gill SL. Telehealth and technological applications in patient-centered care: Implications for pharmacy learners and clinical pharmacists. J Am Coll Clin Pharm. 2021; 4( 8): 1044- 1055. https://doi.org/10.1002/jac5.1490
Reviews, Commentaries, and Opinions describing the need for Medication Management Programs.
- Silva Almodóvar A, Nahata MC. Clinical utility of medication-based risk scores to reduce polypharmacy and potentially avoidable healthcare utilization. Pharmaceuticals. 2022;15(6). doi: 10.3390/ph15060681.
- Silva Almodóvar, A. Nahata, MC. (2021) Implementing Clinical Decision Support Tools and Pharmacovigilance to Reduce the Use of Potentially Harmful Medications and Health are Costs in Adults With Heart Failure. Front. Pharmacol. 12:612941. doi: 0.3389/fphar.2021.612941
- Bingham, J.; Black M, Anderson EJ, Li, Y , Tosell Ni, Fox S, Martin JR, Axon DR, Silva Almodovar, A.; Impact of Telehealth Interventions on Medication Adherence for Patients With Type 2 Diabetes, Hypertension, and/or Dyslipidemia: A Systematic Review [published online ahead of print, 2020 Aug 20]. Ann Pharmacother. 2020;1060028020950726. doi:10.1177/1060028020950726
Other Research Conducted at the Medication Management Program
- Liu L, Li F, Shi H, Nahata MC. The Efficacy and Safety of Vonoprazan and Amoxicillin Dual Therapy for Helicobacter pylori Infection: A Systematic Review and Network Meta-Analysis. Antibiotics. 2023; 12(2):346. https://doi.org/10.3390/antibiotics12020346
- Liu L, Nahata MC. Vonoprazan With Amoxicillin or Amoxicillin and Clarithromycin for the Treatment of Helicobacter pylori Infection [published online ahead of print, 2023 Jan 23]. Ann Pharmacother. 2023;10600280221149708. doi:10.1177/10600280221149708
- Liu L, Silva Almodóvar A, Nahata MC. Medication Adherence in Medicare-Enrolled Older Adults with Chronic Obstructive Pulmonary Disease before and during the COVID-19 Pandemic. J Clin Med. 2022;11(23):6985. Published 2022 Nov 26. doi:10.3390/jcm11236985
- Ramey OL, Silva Almodóvar A, Nahata MC. Medication adherence in Medicare-enrolled older adults with asthma before and during the coronavirus disease 2019 pandemic [published online ahead of print, 2022 Feb 25]. Ann Allergy Asthma Immunol. 2022; S1081-1206(22)00121-1. doi:10.1016/j.anai.2022.02.010
- Silva Almodóvar A, Nguyen D, Nahata MC. Evidence Needed for Efficacy of Antidepressant Medications Among Patients With Rheumatoid Arthritis [published online ahead of print, 2022 Jan 7]. Ann Pharmacother. 2022;10600280211062271. doi:10.1177/10600280211062271
- Silva Almodóvar, A, Surve S, Axon DR, Cooper D, Nahata MC. Self-Directed Engagement with a Mobile App (Sinasprite) and Its Effects on Confidence in Coping Skills, Depression, and Anxiety: Retrospective Longitudinal Study. JMIR Mhealth Uhealth. 2018 Mar 16;6(3):e64.