Physician-Led Point Of Care Medication Delivery Yields Up To 30% Improvement In Key Medication Adherence

PR Newswire

MIAMI, July 18, 2016 /PRNewswire/ -- University of Miami and ChenMed investigators funded by the Robert Wood Johnson Foundation today announced that a two-year clinical study involving 800 diabetic Medicare members in South Florida shows that medication adherence increases from 17 to 29 percentage points for hypertension, statins and antidiabetic medications when a physician-led point of care medication delivery system is used. Plus, medication adherence among African American seniors in the study improved from 20 to 30 percentage points, depending upon the medication class.

Findings published today by The American Journal of Managed Care underscore that even among diabetic patients at goal for low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (A1C), and systolic blood pressure, substantial gains in medication compliance can be achieved when elderly patients receive prescriptions at the time of their medical appointments with primary care physicians (PCPs). AJMC is the leading peer-reviewed journal dedicated to issues in managed care.

"The medical community has long known that lack of medication adherence increases morbidity and mortality in ways that also create up to $170 billion in additional medical expenses each year," explains Jessica Chen, MD, Chief Quality Officer for ChenMed, a U.S. leader in providing affordable care and superior medical experience to seniors. "We strongly favor having our physicians investing the time needed to truly nurture relationships with patients, including real-time discussion of each and every prescribed medication."

Previous studies published by American Journal of Geriatric Pharmacology, Journal of General Internal Medicine, Journal of American Medical Association, and Mayo Clinic Proceedings have found that 20 to 50 percent of patients with complex illnesses, including heart failure and type 2 diabetes, have inadequate adherence to medications known to significantly improve clinical outcomes.

"Medication adherence is a vital measurement for physician performance," underscores the study's lead investigator, Ana Palacio, MD, MPH, Associate Professor, Miller School of Medicine at the University of Miami. "Our study shows clear a clear improvement in medication adherence when medications are delivered to elderly patients with diabetes at the time of clinical encounters with their primary care physicians."

The study, which used an automated point of care medication delivery system (POCMDS) containing pre-sealed labeled medications that are dispensed when ordered by physicians, prioritized use of generic medications between Dec. 15, 2010 and Dec. 14, 2012.

Having witnessed, during the study, how patient satisfaction levels dramatically increased when PCPs delivered prescribed medications, ChenMed refined its point of care medication delivery approach to further increase care team interaction with patients receiving physician-prescribed medications at Chen Senior Medical Center and JenCare Senior Medical Center locations. The integrated medical practice with 37 centers in six states replaced automated POCMDS equipment with pharmacy technicians who also make courtesy reminder-to-take-medicine calls to elderly patients benefiting from easy access to PCPs year-round and its physician-led point of care medication delivery system.

"We're earning even more trust among our patients, by reinforcing PCP-led discussion of medications during patient appointments to answer any questions patients might have, with additional touch points by our pharmacy technicians to further encourage compliant use of prescribed medications," adds Dr. Chen.

ENHANCED PATIENT SATISFACTION
"Enhancing patient satisfaction is a key consideration when adopting a PCP-led point of care medication delivery system," notes Leonardo Tamariz, MD, MPH, Chief of the Miami Veterans Affairs Institutional Review Board. "After all, while the relationship between medication refills and intermediate clinical outcomes is well established, few things could negatively impact HEDIS performance measures (Healthcare Effectiveness Data and Information Set) as much as low patient satisfaction levels."

Patient satisfaction findings among the diabetic seniors participating in the study just published by American Journal of Managed Care include: 87 percent say PCP-led point of care medication delivery improves ability to take medications; 80 percent perceive enhanced quality of care from their PCP; 76 percent note improvement in physician patient communication; and 76 percent report that PCP-led point of care medication delivery is more convenient than filling prescriptions at retail pharmacies.

NEXT STEPS
Future studies with larger samples, should evaluate the impact of physician-led point of care medication delivery among diverse populations, with an eye toward better quantifying health outcomes and overall costs. The current study shows large improvements in medication adherence among low-to-moderate income seniors receiving care in a capitated health system.

ABOUT UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE
Leonard M. Miller School of Medicine and the University of Miami Health System strive to be the leading academic medical center in Florida. The University of Miami Health System is comprised of three university hospitals, including its acute-care University of Miami Hospital, and specialty hospitals Bascom Palmer Eye Institute, Sylvester Comprehensive Cancer Center; three major affiliated institutions, Jackson Memorial Hospital, Holtz Children's Hospital, and Miami VA Medical Center; and more than 30 outpatient facilities. and the campus effectively handles more than 1 million patient encounters annually.

Ranked number 44 in the 2017 edition of "Best Graduate Schools" published by U.S. News & World Report, the Miller School consistently delivers high-caliber, compassionate health care; advances innovative research; and educates the next generation of medical leaders. The Miller School of Medicine has risen 12 spots in the past 10 years in U.S. News' annual ranking of the nation's top research medical schools.

ABOUT CHENMED
ChenMed -- which successfully operates a dozen Chen Senior Medical Center locations in Florida plus 25 JenCare Senior Medical Center locations in Georgia, Illinois, Kentucky, Louisiana and Virginia -- also provides operational support and risk focused end-to-end technologies helping more than 150 medical practices nationwide deliver superior outcomes for seniors with Medicare Advantage.

Committed to transparency and accountability, ChenMed facilitates satisfaction surveys of about 30 percent of its weekly patient volume and consistently yields industry-leading Net Promoter Scores. For example, the 2015 ChenMed Net Promoter Score average was 90%, about eight times better than the 12% average Net Promoter Scores achieved by the health insurance industry.

The innovative ChenMed success formula for senior health includes increased access to senior focused primary care physicians and specialist doctors, daily walk-up appointments, door-to-doctor transportation, on-site labs, on-site x-ray, acupuncture, and on-site medication delivery services. The PCP-coordinated care available at nearly 40 Chen and JenCare Senior Medical Center locations primarily attracts seniors with multiple chronic and complex diseases. The clinical model is specifically designed to improve the outcomes of the 10-15% of the population that accounts for the majority of health care costs.

Read the Forbes story on how the family-owned, physician-led business is transforming medicine; or The Economist reporting "Medicare patients at ChenMed spent nearly 40 percent fewer days in hospital than the national average."; or Medical Economics noting ChenMed "may be the best primary care system in the U.S."; or The Commonwealth Fund Transforming Care (Mar. 24, 2016) saluting ChenMed and others for "patient-centric cultures that are built on empathy and learning"; or watch the two-minute FOX Business segment (April 23, 2016).