TY - JOUR
T1 - Medication reconciliation and therapy management in dialysis-dependent patients
T2 - Need for a systematic approach
AU - Pai, Amy Barton
AU - Cardone, Katie E.
AU - Manley, Harold J.
AU - St. Peter, Wendy L.
AU - Shaffer, Rachel
AU - Somers, Michael
AU - Mehrotra, Rajnish
PY - 2013/11/7
Y1 - 2013/11/7
N2 - Patients with ESRD undergoing dialysis have highly complex medication regimens and disproportionately higher total cost of care comparedwith the generalMedicare population. As shown by several studies, dialysis-dependent patients are at especially high risk for medication-related problems. Providing medication reconciliation and therapy management services is critically important to avoid costs associated with medication-related problems, such as adverse drug events and hospitalizations in the ESRD population. The Medicare Modernization Act of 2003 included an unfunded mandate stipulating that medication therapy management be offered to high-risk patients enrolled in Medicare Part D. Medication management services are distinct from the dispensing of medications and involve a complete medication review for all disease states. The dialysis facility is a logical coordination center for medication management services, like medication therapy management, and it is likely the first health care facility that a patientwill present to after a care transition. A dedicated and adequately trained clinician, such as a pharmacist, is needed to provide consistent, high-quality medication management services. Medication reconciliation and medication management services that could consistently and systematically identify and resolve medication-related problems would be likely to improve ESRD patient outcomes and reduce total cost of care. Herein, this work provides a review of available evidence and recommendations for optimal delivery of medication management services to ESRD patients in a dialysis facility-centered model.
AB - Patients with ESRD undergoing dialysis have highly complex medication regimens and disproportionately higher total cost of care comparedwith the generalMedicare population. As shown by several studies, dialysis-dependent patients are at especially high risk for medication-related problems. Providing medication reconciliation and therapy management services is critically important to avoid costs associated with medication-related problems, such as adverse drug events and hospitalizations in the ESRD population. The Medicare Modernization Act of 2003 included an unfunded mandate stipulating that medication therapy management be offered to high-risk patients enrolled in Medicare Part D. Medication management services are distinct from the dispensing of medications and involve a complete medication review for all disease states. The dialysis facility is a logical coordination center for medication management services, like medication therapy management, and it is likely the first health care facility that a patientwill present to after a care transition. A dedicated and adequately trained clinician, such as a pharmacist, is needed to provide consistent, high-quality medication management services. Medication reconciliation and medication management services that could consistently and systematically identify and resolve medication-related problems would be likely to improve ESRD patient outcomes and reduce total cost of care. Herein, this work provides a review of available evidence and recommendations for optimal delivery of medication management services to ESRD patients in a dialysis facility-centered model.
UR - http://www.scopus.com/inward/record.url?scp=84887298834&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84887298834&partnerID=8YFLogxK
U2 - 10.2215/CJN.01420213
DO - 10.2215/CJN.01420213
M3 - Comment/debate
C2 - 23990162
AN - SCOPUS:84887298834
SN - 1555-9041
VL - 8
SP - 1988
EP - 1999
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 11
ER -