Targeted Support

Given the aging population in the United States, and the corresponding increase in polypharmacy, the risk of ADEs in the U.S. is rising exponentially. Most ADEs are preventable through the identification of multi-drug interactions and appropriate levels of intervention. Identification and prevention of potential ADEs could significantly reduce health care spending and meaningfully improve patient outcomes on an individual and societal level.

TRHC’s Targeted Support programs increase member awareness of optimal medication use by offering personalized medication regimen reviews along with pharmacy-driven education and consultation.

Initiative Elements.
Population-based risk analysis and stratification based on prescription claims data.
Plan members are analyzed and stratified into risk categories using TRHC’s proprietary medication risk stratification software. Progressing from Low Risk to Major Risk, the members are assigned to relative risk groups (low, moderate, high, very high, and major risk). Factors contributing to this score include number of medications, competitive inhibition score, sedative burden, heart rhythm risk, and more.

Communication to Plan members about the Initiative and proposed benefits.
Member communications are developed in conjunction with the Plan, and distributed. Number and frequency of mailers is dependent upon response rate.

Telephonic outreach & medication reconciliation for highest risk members.
Members are invited to participate in the program, and detailed medication lists are requested from those who opt-in. If not provided by Plan, TRHC obtains dosing and administrating time information as well. (Claims databases do not fully capture patient medication-taking behaviors and do not include over-the-counter medications, thus this data-gathering step is important for safety.)

PharmD medication regimen review and consultation.
TRHC Medication Risk Mitigation-trained clinical pharmacists review members’ reconciled medication lists and develop recommendations for optimizing medication regimens and reducing multi-drug interactions. Pharmacists consult with members, communicating medication safety information answering any questions.

“Refrigerator Profile” mailed to members pursuant to consultation.
A personalized “Refrigerator Profile” (patient-friendly medication administration time-of-day chart) is produced from the member’s complete medication list that incorporates recommendations/adjustments made during the PharmD call. TRHC pharmacists use proprietary Medication Risk Mitigation software to create the time-of-day profile, which is competitive inhibition informed (i.e., using affinity coefficient for each drug to its metabolizing enzyme to identify the appropriate time of administration to avoid competitive inhibition drug interactions). These are mailed with instructions for use.