Telephone-Based Cardiovascular Medication Therapy Management in Medicare Part D Enrollees With Diabetes

Published by: Eleanor O. Caplan, PharmD, PhD; Mignonne C. Guy, PhD; Jean Chang, BS; Kevin Boesen, PharmD

Objectives: The purpose of this study was to evaluate the impact of pharmacist-delivered medication therapy management (MTM) services via telephone (enhanced MTM intervention) versus the impact of an informative detailed medication letter sent via mail (minimal MTM intervention) on patients’ acceptance of guideline-recommended pharmacotherapies, specifically angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) and statins.

Study Design: A retrospective database analysis was completed using pharmacy claims and enrollment data from 1 national pharmaceutical benefits manager.

Methods: Medicare Part D beneficiaries with diabetes, managed by 1 pharmacist-based medication management center, received either: 1) a pharmacist’s recommendation, delivered via telephone, to add an ACE inhibitor or ARB and/or a statin to existing therapy, or 2) an informative letter detailing current therapies. The primary outcome measure was acceptance of guideline-recommended therapy determined by the presence of at least 1 prescription claim for the target drug in the postintervention period. Propensity score matching and conditional logistic regression methodologies were used to assess the comparative effectiveness of the interventions.

Results: Patients who received the telephone intervention were 6.33 times more likely to be taking both medications during the postintervention period compared with those who received the letter intervention (P <.001). A greater proportion of patients who received the telephone intervention were taking both drugs during the postintervention period, with the greatest difference in those initially receiving a statin to which ACE inhibitor/ARB therapy was added (41.18% vs 7.23%).

Conclusions: Telephone-based MTM services provided to Medicare Part D beneficiaries with diabetes positively impacted acceptance of guideline-recommended ACE inhibitor/ARB and/or statin therapies relative to the letter intervention.