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Study to evaluate greater role for ND pharmacists

FARGO -- Caregivers' best efforts to treat costly chronic diseases can suffer when patients fail to take their medications as prescribed.

Nationally, the prescription drug compliance rate is estimated at 50 percent, according to researchers.

An initiative to give North Dakota pharmacists a more active role in the team management of chronic disease aims to boost medication compliance to improve patient outcomes.

A group of partners including Blue Cross Blue Shield of North Dakota has provided a grant to pharmacy researchers at North Dakota State University to evaluate medical management services provided by pharmacists.

The researchers will evaluate health outcomes as well as patient satisfaction and cost of services as delivered by care teams in the so-called medical homes led by primary care doctors.

"We want to improve medication compliance," said David Scott, who is conducting the research with fellow NDSU pharmacy professor Daniel Friesner.

"If we can get people to take medications as prescribed, it should reduce emergency room visits and hospitalizations," Scott said. "These are very costly venues of care."

The study will place North Dakota at the forefront of efforts to better coordinate care between pharmacists and doctors, said Scott, the study's lead researcher.

The pilot study involves Thrifty White Pharmacy, one of the granting partners, which has 21 locations in North Dakota communities. The grant was awarded by the National Association of Chain Drug Stores Foundation.

Pharmacists will augment Blue Cross Blue Shield's MediQHome care management program, in which 70 percent of North Dakota physicians participate.

The program focuses on better managing and preventing nine chronic health conditions, including diabetes, high blood pressure and asthma.

Retail pharmacists are on the frontlines of health delivery and can play an important role, said Tom Christensen, manager of pharmacy management at Blue Cross Blue Shield of North Dakota.

"Pharmacists really are, if not the most, among the most accessible health care providers," he said, adding that they often have more contact with customers than physicians.

In fact, Blue Cross Blue Shield began an initiative to give pharmacists a greater role in what is called medication therapy management when the NDSU research opportunity came along.

Software provided by Prime Therapeutics, which supports the project with a computer program that joins medical and pharmaceutical and clinical information to guide and track better care.

Another partner in the research project, Outcomes MTM, has a national network of pharmacists who provide medication therapy management services.

The Thrifty White pharmacists will provide medication management services, including advising patients about the benefits of taking all medications as directed, and administering immunizations.

Blue Cross Blue Shield will reimburse pharmacists for their services, but expects to recoup its investment through improved health and better patient outcomes, Christensen said.

"I can't put a dollar figure on that, but what we do know is gaps in care exist, and when they do, that leads to poorer outcomes," he said, which translate into higher costs.

The two-year NDSU study will provide unbiased evaluations and measurements of the program's results, Christensen said.

"This is an ambitious study," he said, "the ambition being with the scale of it."