Tips for Scripts: Provider Best Practices for Medication Management

As the Manager of Clinical Pharmacy Services, I promote clinically appropriate, evidence-based therapies for prescribing quality medication use and cost savings to Privia Medical Group Physicians. It’s just one of the many ways that Privia removes burdens from our physicians so they can focus on providing quality care to their patients.  
Looking to reduce overall medication cost expenditure and improve quality through data-driven care? Below, I’ve outlined some pharmacist-recommended strategies you can use to optimize medication management in your day-to-day interactions with your patients. Read on for useful tips to reduce inappropriate utilization and control costs:
Reduce Inappropriate Utilization
Perform medication reconciliation during each patient interaction: This will ensure the plan of care is up-to-date with what medications the patient is taking and that all relevant members of your staff are informed of what the patient is taking. This list should include the drug name, dosage, frequency taken, and route. Compare the list created from the patient to what exists in their medical record to ensure accuracy and use it to identify opportunities for education on medication adherence.
Keep an Eye on Your State’s Prescription Monitoring Program (PMP) for Controlled Substances: Most states now have prescription drug monitoring programs (PDMPs or PMPs) in place. The purpose of these programs is to reduce prescription drug abuse and diversion. Routine use of PDMPs or other opioid safeguards can lead to decreased opioid use and shorter durations. You can use your state PDMP to ensure that you’re being a safer prescriber and to identify patients who are doctor or pharmacy shopping, using dangerous med combos, or not filling prescriptions at all. Consider incorporating a PDMP review into pre-visit planning so you’re aware of issues before seeing the patient.  If your patient’s info isn’t in the PDMP, consider possible legitimate reasons; they may have been filling prescriptions from nearby states, there may be delays in pharmacy data uploads, or mix-ups with similar names or birth dates, etc.   
Control Your Costs
Address Medication Adherence at each office visit.  A recently published study found that for a number of chronic medical conditions—diabetes, hypertension, hypercholesterolemia, and congestive heart failure—higher rates of medication adherence were associated with lower rates of hospitalization and a reduction in total medical costs. Here are a few strategies you can use to increase patient adherence:

• Identify barriers to adherence and work with the patient to create a plan.
• Look for red flags. Consider adherence a vital sign to be assessed at each visit.
• Ask open-ended questions about how your patients are doing with their meds or how often they miss doses.
• If in doubt, consider asking your pharmacy colleagues about refill patterns.
• Recommend routines and reminders linking doses with daily activities, med lists, smartphone apps or alarms, pillboxes, etc.

Look for Cost Saving Opportunities.  Keep in mind that a 1% increase in generic dispensing equals a 1% reduction in pharmacy benefit plan costs and a 2.5% reduction in total health care costs. While reviewing a patient’s medications, look for:

• Duplicates or overlapping drugs or supplements that can be eliminated; reduce polypharmacy where necessary if a patient has multiple providers.
• Brand products that can be switched to generics or therapeutic alternatives.
• Drugs that are being used to treat preventable side effects of other drugs.
• Additional switches that can make drugs more affordable, such as cost-effective OTC alternatives to some prescription drugs.

Find this information helpful? Privia Medical Group physicians receive this and more. We’re an outcome-obsessed medical group that helps physicians succeed under value-based contracts through patient-centered care.
Interested in how Privia may be able to help you become a more effective provider? Contact us.