William R. Doucette, Randal P. McDonough, Fischer Herald, Amber Goedken, Jenn Funk, Michael J. Deninger

The aim of this work was to assess the effects of continuous medication monitoring (CoMM) on: 1) total costs of care; 2) proportion of days covered (PDC) rates; and 3) use of high-risk medications by older patients. Cohort design. A reimbursed CoMM program was implemented in a community pharmacy to manage problems with medications being dispensed to beneficiaries of a commercial insurer. Pharmacists assessed medications being dispensed, interacted with patients in the pharmacy, and documented their actions. Claims data compared the pharmacy performance for 3 study groups after 12 months of CoMM: group 1, patients with prescriptions dispensed only at the study pharmacy; group 2, patients with prescriptions dispensed from the study pharmacy and other pharmacies; and group 3, patients with no prescriptions dispensed by the study pharmacy. For the analyses, individuals in group 1 (CoMM-only group) were matched with those in group 2 and group 3 by age band, gender, risk category, and utilization band. The variables of interest were per-member per-month total health care costs, medication adherence (PDC), and the use of high-risk medications in older adults. At 12 months, per-member per-month total costs of care were significantly lower (P < 0.05) for group 1 versus group 2 ($309 difference) and for group 1 versus group 3 ($298 difference). At 12 months the average PDC for group 1 was significantly higher than for group 2 (3.8% difference) and group 3 (2.6% difference). No significant differences were found in the use of high-risk medications. A CoMM program in a community pharmacy was associated with lower total costs of care and better medication adherence. Paying pharmacists to proactively address the safety, effectiveness, and adherence of medications at the time of dispensing can support optimization of medication therapy.