Medicare Part D took effect in January 2006 with requirements for prescription drug plans to provide medication therapy management (MTM) services to targeted Medicare beneficiaries. The use of Medicare Part D MTM is voluntary by Medicare beneficiaries; no research evidence is available that can inform policy makers of the beneficiary and provider access-level circumstances under which older adults are more likely to demand MTM-like services. The objective of a study by Brooks and coworkers was to describe the effects of the characteristics of older adults and their provider access on the demand for MTM services using data from a unique pre-Medicare Part D program for Medicare-eligible older adults in Iowa. The investigation featured a retrospective cohort study using enrollment, claims, and provider data from the Iowa Priority Prescription Savings (IP) Program. The dependent variable was whether the IP members obtained the MTM service offered by the program. Logistic regression was used to assess whether IP member characteristics and their provider access affected the probability of the IP member to obtain the MTM service. Demand for the service varied with IP member age, gender, monthly number of drugs taken, monthly prescription drug spending, self-reported health status, having alternative insurance, and seeing multiple physicians. Increased access to pharmacies promoting the service increased IP member demand.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that the demand for MTM-like services varied with the characteristics of older adults and their access to providers that promote the service. Older adults who viewed themselves as sicker and those with more complex medication regimens appeared more likely to demand a service, suggesting that the benefits of the service are either more important or more recognizable to them. However, it appears that older adults require contact with pharmacies that promote MTM services to recognize this value.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: If you are an older patient, the study suggests that you contact pharmacies that provide medication therapy management services. This should not only enable you to better control the multiple medications you may take and, as a consequence, improve you control over chronic conditions.

JM Brooks et al. Factors affecting demand among older adults for medication therapy management services. Research in Social & Administrative Pharmacy: RSAP, 2008;4:309-319.