Outcomes of medication therapy review in a family medicine clinic

Objective: To evaluate the effects of pharmacist-conducted medication therapy review (MTR) and intervention on the quality of care of patients in a family medicine clinic. Design: Prospective, observational, cohort study. Setting: Family medicine clinic in Minnesota during 2000-2001. Patients: Patients were enrolled in a statewide nonprofit managed care organization; selected patients were seen by a clinical pharmacist. Intervention: Following MTR, medication-related problems (MRPs) were identified and resolved. Main outcome measures: MRPs identified and resolved, improvement in clinical status, achievement of therapeutic goals, important medication use, and reduction in number of medications. Results: 92 patients were included in the study, with a total of 203 patient encounters. MRPs were identified in 90% of patients, with a total of 250 identified. Overall status of medical conditions improved in 45% of patients, 46% stayed the same, and 9% declined (P < 0.001). Significant improvement in status was found for hypertension (P = 0.007), dyslipidemia (P = 0.002), and asthma (P = 0.011). Significant improvement was seen for aspirin use for myocardial infarction prevention (50% vs. 93%, P = 0.031) and inhaled steroids for asthma (36% vs. 64%, P = 0.031). The number of medications was reduced from an average of 3.92 to 3.04 (P < 0.001) per patient. Conclusion: MTR and intervention by a pharmacist positively affected quality of care in this family medicine clinic.