ADOPTION OF THE NOVA SCOTIA (CANADA) COMMUNITY PHARMACY MEDICATION MANAGEMENT PROGRAM, 1-YEAR POST-INITIATION

Main Article Content

Heidi J. Deal
Charmaine A. Cooke
Ethel M. Langille Ingram
Ingrid S. Sketris

Keywords

medication management review, pharmacy reimbursement, medication therapy management, pharmacy services

Abstract

Background


Pharmacists conduct medication reviews to optimize drug therapy. Each jurisdiction implements and funds these programs differently. 


Methods


This retrospective analysis included 294 pharmacies and 105,000 beneficiaries enrolled in the Nova Scotia Seniors’ Pharmacare Program. Prescription and service claims data from this program were analyzed to determine type and number of beneficiaries receiving a medication review, number and predictors of pharmacies completing reviews, and number of prescribed medications 6-months before and 6-months after the review.


Results


428 medication reviews were conducted and billed by 33% of Nova Scotia pharmacies (1–50 reviews per pharmacy per year). The mean number and range of medications before the review were 10.8 (4-28) and following the review 10.4 (0–24), with an average decrease of 0.4 medications (95% CI 0.1–0.6), p 5 .0043). Patients receiving a review had a mean age of 75.2 years; 64.9% were female. Most pharmacies conducted reviews when patients reached their annual copayment (93%).


Conclusions


Approximately 33% of pharmacies billed at least one medication review in the first year of the program. In spite of a $150 reimbursement per community pharmacy medication review, only 428 reviews were conducted over a 13-month period for a population of over 100,000 seniors.


Results suggest financial reimbursement alone is not sufficient to implement a medication management program; health systems need to determine patient, pharmacist, pharmacy and health system level strategies to implement medication reviews more broadly.

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