Studies from Duke University School of Medicine Further Understanding of Managed Care and Specialty Pharmacy (Characterizing Medicare Medication Therapy Management program enrollees with central nervous system-active polypharmacy): Drugs and Therapies – Managed Care and Specialty Pharmacy

2026 JAN 07 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Drugs and Therapies - Managed Care and Specialty Pharmacy is the subject of a report. According to news reporting originating from Durham, North Carolina, by NewsRx correspondents, research stated, “The Medicare Part D Medication Therapy Management (MTM) program uses comprehensive medication reviews (CMRs) and targeted medication reviews to address medication-related problems in older adults. One such problem is central nervous system (CNS)-active polypharmacy, which is associated with impaired cognition and falls in older adults.”

Our news editors obtained a quote from the research from the Duke University School of Medicine, “To date, little is known about the prevalence of CNS-active polypharmacy among MTM enrollees and how they might differ from MTM enrollees without CNS-active polypharmacy; such insights would be helpful to MTM programs developing interventions to reduce CNS-active polypharmacy. To (1) estimate the prevalence of MTM enrollees with CNS-active polypharmacy in a nationwide cohort and (2) compare patient characteristics and MTM service use of MTM enrollees with CNS-active polypharmacy vs without. Cross-sectional, observational study of 2019-2021 Medicare 5% fee-for-service data linked to 2020-2021 MTM data. Patient characteristics and MTM use were compared between MTM enrollees with and without CNS-active polypharmacy. Among 38,733 MTM enrollees in 2021, 4,144 (10.7%) experienced CNS-active polypharmacy. Compared with those without CNS-active polypharmacy, the CNS-active polypharmacy cohort was more likely to be male (72% vs 55%, standardized mean difference [SMD] = 34.7%), be dually enrolled in Medicaid (42% vs 24%, SMD = 41.1%), and have greater comorbidity burden (Charlson Comorbidity Score of 6.0 vs 5.0, SMD = 13.2%). The CNS-active polypharmacy cohort also had more prior-year health care utilization, such as being more likely to have an inpatient stay (37.5% vs 29.0%, SMD = 18.1%) or emergency department visit (53.7% vs 43.0%, SMD = 21.6%), as well as number of outpatient visits (7.0 vs 5.0, SMD = 20.8%) and number of unique prescription drugs (21.0 vs 15.0, SMD = 91.9%). The number of targeted medication reviews received was greater in the CNS-active polypharmacy cohort, but a lower proportion (35% vs 39%) participated in a CMR. More than 1 in 10 MTM enrollees experience CNS-active polypharmacy, which is higher than the general Medicare fee-for-service beneficiary population. MTM enrollees with CNS-active polypharmacy are more likely to be male, dually enrolled in Medicaid, and with greater comorbidity burden and prior-year use of health care and medications, suggesting that interventions for this population may need to account for additional clinical and socioeconomic needs.”

According to the news editors, the research concluded: “Despite being at greater risk of adverse drug events including impaired cognition and falls, just over one-third of MTM enrollees with CNS-active polypharmacy participate in a CMR, suggesting opportunity for more targeted outreach and intervention by MTM programs, Part D plan sponsors, and Centers for Medicare & Medicaid Services.”

This research has been peer-reviewed.

For more information on this research see: Characterizing Medicare Medication Therapy Management program enrollees with central nervous system-active polypharmacy. Journal of Managed Care & Specialty Pharmacy, 2026;32(1):85-94. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news editors report that additional information may be obtained by contacting Lauren E. Wilson, Dept. of Population Health Sciences, Duke University School of Medicine, Durham, NC. Additional authors for this research include Anna Hung, Valerie A. Smith, Richard Erickson, Kelli Tharpe, Nicole Brandt, Timothy S. Anderson, Oliver Valdez, Melissa Castora-Binkley, Juliessa Pavon, Susan N. Hastings, Matthew L. Maciejewski and Caroline E. Sloan.

Publisher contact information for the Journal of Managed Care & Specialty Pharmacy is: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

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