Shifting from Legacy Medication Management to Intelligent Medication Optimization Image

Shifting from Legacy Medication Management to Intelligent Medication Optimization

Published by Sandy Bonfin, PharmD, BCPS on Oct 23, 2023 10:45:36 AM

 

How a drug reacts in the body varies from person to person. Factors such as age, weight, and kidney function all have an impact on how medications should be taken. As such, the optimization of drug therapy can become complex, especially for patients with multiple medications.

With over six billion prescriptions filled at U.S. pharmacies each year, legacy medication management has lacked the ability to deliver scalable, repeatable patient care that is personalized to each individual’s unique and evolving health needs. In this article, medical and pharmacy leaders will learn how medication intelligence enables care teams to optimize medications instead of simply managing them.

In this article, we discuss:

Definitions: Medication Management, Medication Intelligence, and Medication Optimization

Medication management services are  delivered by clinicians to assist patients in managing their medications. It focuses on medication safety, efficacy, adherence, and appropriateness to ensure optimal therapeutic outcomes. Medication management processes are often heavily manual and patient benefits may be limited to the areas of focus.

Medication intelligence results from combining data science and clinical expertise with multidimensional data to identify which patients need a medication-related intervention, why they need it, what intervention they need, when to intervene, and how to intervene. Medication intelligence supports clinical decision-making and enables care teams to help patients achieve their health goals and reduce the total cost of care.

Medication optimization is a different way to think about managing medication therapy. While legacy medication management often lacks the medication intelligence needed to deliver truly personalized care, medication optimization focuses on the whole patient to ensure they are on the safest, most effective medication for their unique and evolving health needs, including physical, behavioral, and economic.

Intelligent Medication Optimization In Action

Medication intelligence powers medication optimization by providing care teams with the actionable data they need to provide care that takes the whole person into account. While legacy medication management struggles to overcome medication-related problems (MRPs) beyond adherence, intelligent medication optimization addresses the full scope of MRPs to help patients achieve their goals of therapy. Let’s take a look at a few examples:

Identifying and resolving over- or under-dosing

One of the most common sources of medication-related problems involves dosing errors. Patients often have health conditions treated with too little or too much of the correct medication. Medication intelligence analyzes patient data to optimize therapy, ensuring patients are on the appropriate dosage for their condition.

For example, one Arine patient was on multiple medications and experienced headaches and uncontrolled blood pressure. In Arine’s initial analysis, the platform identified that the patient was non-adherent to their anti-hypertensive regimen, triggering an outreach from a care team member. Through the patient discussion, the care team learned that the home health aide had been administering one tablet of Metoprolol Succinate each morning instead of two tablets, contributing to extremely elevated blood pressure readings. In addition, through personalized questions from the platform, the care team learned about other concomitant conditions the patient was managing, including that the individual was a smoker struggling to quit.  Armed with this information, the Arine team helped the individual to update their medication regimen for blood pressure, but also supported the patient in initiating nicotine replacement therapy.  By the next doctor’s appointment, the patient’s blood pressure was controlled and their headaches had resolved.  The individual also ultimately succeeded in quitting smoking, eliminating another key cardiovascular risk factor.

Improving medication safety

Each year, an average of 700,000 Emergency Department (ED) visits occur due to adverse reactions to medications, Such a high number of adverse drug events indicates the value of a scalable way to proactively identify medication-related problems. Research has shown that artificial intelligence can address therapeutic errors. By integrating and analyzing medical claims, pharmacy claims, and data from patient interviews,  Arine’s mediation intelligence platform helps care teams decrease hospitalizations and cost of care by resolving medication-related problems through timely intervention.

One health plan was able to reduce inpatient hospital admission rates by 40% for its Medicaid population by identifying serious drug interactions. For instance, one of their members with epilepsy identified for a comprehensive medication review had visited the ED seven times over the past year for uncontrolled seizures.  During the medication review, it was discovered that the patient had been prescribed Tramadol for chronic pain.  Given that Tramadol can induce seizures, the care team utilized the Arine platform to reach out to the patient’s provider to recommend discontinuation of Tramadol, resolving the patient’s occurrence of seizures and emergency room visits.

Going beyond adherence to improve access

Medication adherence can be challenging to assess, as many factors affect a patient’s ability to adhere to their care plans. For instance, it’s not enough to know that a patient has picked up a prescribed medication from the pharmacy. Care teams must also be able to understand what happens before and after the medication leaves the pharmacy to ensure the patient can access their medication. Does the patient have access to transportation to get to the pharmacy? Can the patient afford the medication? Are the directions practical? Does the patient understand how the medication should be administered?

Arine’s platform analyzes patient data to discover potential adherence issues. Where gaps in the data exist, Arine’s platform triggers SmartQuestions for the care team to fill in the data to identify other adherence or medication-related problems. For example, the medication intelligence platform provides an initial patient assessment, creates patient-specific recommendations based on the initial profile analysis, and prompts the care team to gather additional data from the patient. This analysis provides a full picture of the patient, from therapeutic goals to financial feasibility, and social determinants of health.

Personalizing medication therapy to each patient

Each patient has unique and evolving health needs. These needs include financial factors, social factors, behavioral factors, and disease factors that may change over time. Medication intelligence takes all these factors into consideration and enables care teams to provide evidence-based personalized care. Arine algorithms build actionable care plans based on the needs of each patient and allow clinicians to reach out with timely, appropriate care. Arine’s platform is designed for the continuous collection of data to measure ongoing performance and report on the effectiveness of the patient’s current medication management program to identify if the patient needs a follow-up intervention.

For instance, Arine’s care team discovered one patient with diabetes and hypertension who was not consistently taking her medications due to cost and lack of education on personal diabetes and blood pressure goals. The Arine platform created recommended care plan changes.  The care team also facilitated patient counseling and the development of a written action plan which highlighted the importance of self-monitoring and blood glucose and blood pressure goals. Upon follow-up, the patient received new anti-hypertensive medications, found affordable alternatives for her diabetes regimen based on her health plan’s formulary, and began to monitor her blood pressure regularly. With the appropriate medication and action plan for her unique needs, the patient achieved her diabetes and hypertension goals.

Know the Next Action to Take

Ensuring optimal medication use requires careful coordination of care and communication among prescribers, other healthcare providers, and patients and their caregivers. The therapeutic needs of patients are rapidly changing and the healthcare industry must evolve with them. In order to do that, medication intelligence to enable the optimization of care should become an integral part of modern healthcare. Learn more about the results Arine can achieve through our webinar.

Improving Behavioral Health Outcomes with Medication Intelligence

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