Medication management is the process of evaluating drugs prescribed to a patient to ensure they’re taken properly.
The ultimate goal of comprehensive medication management—which plays a vital role in modern healthcare—is to get the right drugs to the right patients at the right time. When medication regimens are optimized, everything from performance and patient outcomes to the overall cost of care improves.
Of course, in order to optimize your regimens, you need the right checks and balances in place to carefully review drug utilization, identify and close gaps in care, and better manage costs. Let’s talk about the benefits of medication management.
1. Proactive Drug Review
Proactive drug utilization review (DUR) is the ongoing evaluation of prescribing, dispensing, and using medication. The DUR process involves a comprehensive review of a patient’s prescription data and medical history before, during, and after dispensing. This allows room to provide feedback on prescribing habits and educate physicians.
According to the Academy of Managed Care Pharmacy (AMCP), effective medication management is an ongoing process that not only allows for the elimination of unnecessary drugs, but also identifies and addresses common issues, such as:
- Drug-disease contraindications: Are prescribed drugs inappropriate for a specific disease or chronic condition due to potential side effects?
- Drug-drug interactions: Are there any concerns about adverse events due to prescribed medications interacting with other prescriptions?
- Inappropriate drug dosage: Is a patient prescribed too high or too low a dose?
- Patient-specific precautions: Are there safety concerns due to a patient’s age, gender, or another trait specific to the individual?
- Improper duration of treatment: Is the medication prescribed for the right period of time, or does the duration of treatment need to be adjusted?
Another part of medication management is reviewing prescriptions to ensure physicians aren’t overutilizing certain medications. For example, over-prescribing antibiotics when they aren’t necessary can lead to antibiotic resistance and the creation of unwelcome superbugs that are unresponsive to most medications.
2. Closed Care Gaps
Identifying and bridging gaps in care are other significant benefits of medication management. From lack of follow-up and poor communication to medical errors and non-adherence, there are a number of care gaps that can cause adverse events and hinder individual health outcomes.
However, by proactively managing a patient’s medications, you can recognize potential risks—such as poor therapy initiation, which ultimately results in poor medication adherence. If patients aren’t filling their prescriptions, they certainly aren’t taking them according to their treatment plan. Leveraging data and analytics allows pharmacists, payers, and manufacturers to pinpoint potential care gaps and find ways to intervene early on, before any adverse events occur.
For example, medication non-adherence can lead to worsening health conditions, prolonged hospitalization and readmissions, and even mortality. On the other hand, by proactively recognizing and closing gaps in care thanks to medication management, you can prevent the consequences of low therapy initiation, medication non-adherence, and other less-than-optimal scenarios.
3. Decreased Costs
Delivering healthcare is incredibly costly for everyone involved, and managing those costs is essential for health plans. After all, funds are hardly unlimited. In fact, a 2016 study published in the Annals of Pharmacotherapy revealed the estimated annual cost of drug-related morbidity and mortality resulting from non-optimized medication therapy was $528.4 billion, which was equivalent to around 16 percent of total U.S. healthcare expenditures that year.
Even the largest and most successful payer organizations must take the appropriate steps to ensure patient care is as effective as it is cost efficient. Fortunately, comprehensive medication management can both mitigate avoidable costs and improve individual patient outcomes.
How? By ensuring the most affordable, appropriate, and effective medications are prescribed to each patient to reduce costs for both the payer in question and the healthcare system as a whole.
4. Better Outcomes
The end result of proactive drug utilization review, closed care gaps, and decreased costs is better health outcomes for patients. Everything related to medication, from the cost of dispensing to the dosage for administering, is completely optimized and tailored to each patient’s needs.
How AI Can Support Effective Medication Management
It’s easy to see how challenging medication management can be when you're trying to manage everything—utilization, prescribing, costs, adherence, interactions, effectiveness, and more—all at once.
Artificial intelligence (AI) supports effective, efficient medication management by utilizing large and variable data sets to hone in on what’s important for each individual patient and not just their population or demographic. For example, not every patient with diabetes needs to be started on a statin immediately, but individuals with greater risk of developing cardiovascular disease could benefit from taking one to prevent plaque buildup.
AI helps identify those patient-specific variables, enabling truly personalized care that results in better health outcomes. Interested in learning more? Schedule a demo to see AllazoHealth’s AI engine in action.
About the Author
Dr. Linda Schultz
Dr. Linda Schultz is a results-oriented Healthcare Pharmacy Executive who excels at leading transformational, top-notch, interdisciplinary healthcare teams to create and execute outcomes driven clinical operations and account management initiatives. Dynamic and knowledgeable in all healthcare business segments, most passionately within the complex Medicare, Duals and Medicaid markets, she is an accomplished, creative motivator and driver of innovative quality and cost of care pharmacy interventions. Dr. Schultz is currently VP, Customer Success at AllazoHealth, a cutting-edge, healthcare artificial intelligence company. Prior to her leadership role at Allazo, Linda founded and led RxHorizons, LLC., an international healthcare consulting group. Her expertise stems from over 25 years of experience within the Managed Care industry, with a focus on leading, strategizing, developing and implementing pharmacy benefit management activities within national PBMs and health plans.