Improved systems of medication management and increased communication with pharmacists are helping to make the world of pharmacy a kinder, gentler place.
Even more importantly for patients, these things may just be keeping people from going — and being admitted — to the hospital unnecessarily.
These are the findings of a study recently published in “The Journal,” a publication from the Pharmacy Society of Wisconsin.
The article, “A Community Pharmacy Initiative to Decrease Hospital Readmissions by Increasing Patient Adherence and Competency of Therapy,” was authored by administrators of MetaStar, a nonprofit healthcare consulting service, and Phil Berce, owner of Good Value Pharmacy.
Showcasing innovations and practices implemented by Good Value Pharmacy along with Kenosha County medical professionals and agencies, the three-year study found that “pharmacy-based interventions” and “compliance packaging” are contributing to reduced hospital admissions in our area.
The study, conducted from Jan. 1, 2014, through Dec. 31, 2016, reported on initiatives Good Value Pharmacy had had in place for several years, said Alex Berce, managing pharmacist and brother of pharmacy owner Phil Berce.
“There are some convincing results saying we’re keeping people out of the hospital. That was the goal. Not just anecdotal, but data showing we’re helping people and saving them money,” Alex Berce said.
The study highlighted the positive impact of Good Value Pharmacy’s community-based packaged pharmaceuticals program. “Instead of putting medications into bottles, medications are put into packaging to help the patient know when to take their medicine,” Alex Berce said.
Known as compliance packaging, this is a form of packaging medications that labels each dose by date, time, patient and drug.
“Compliance packaging was inspired by the need for it years ago when we began to serve adult family homes and small (community based residential facilities). To follow state regulations, the pharmacy provided pre-packaged medication dosages,” Alex Berce said. “As we got that system in place, we realized it would be awesome for people in their own homes as well.”
The combination of compliance packaging along with increased pharmacist-physician-patient communication became known as Patient Adherence and Competency of Therapy, or PACT.
PACT was spearheaded by Phil and Alex Berce’s father and the founder of Good Value Pharmacy, the late Phil Berce. “Dad had the foresight to provide compliance packaging (to customers). He supervised the program when GVP had its first location on 80th Street,” Alex Berce said.
The study began after Alex Berce, who had just graduated from pharmacy school, decided to document how the improved packaging was helping their customers.
“We knew it was helping patients because they said it was helping them, improving quality of life, and family members saying it was making it easier on their lives,” Alex Berce said.
To document and promote their program, Good Value Pharmacy partnered with MetaStar, which does data analysis for Medicare and the Kenosha County Care Transitions Coalition.
The coalition was founded in 2011 by medical professionals and social service agencies with a mission to troubleshoot issues encountered by patients going from the hospital to home or to other care centers.
“According to an initial investigation, one of five Medicaid beneficiaries is readmitted to the hospital within 30 days. And of those, 75 percent of these had been deemed unnecessary,” said Helen Sampson, quality coordinator for the Aging and Disability Resource Center and coalition coordinator.
“Had they gone to see their doctor and gotten their medications fixed, they wouldn’t have had to go back to the hospital,” Sampson said.
Realizing that medication compliance was a big piece of the solution, the coalition reached out to Good Value Pharmacy and its PACT program. “Phil Berce jumped at the chance to participate,” Sampson said.
An important element of PACT is pharmacist engagement at every step of the process, noted Alex Berce.
“The pharmacists and pharmacy technicians as a team are acting as an intermediary between doctor and patient,” he said. The pharmacist also talks to the patients and makes a decision about whether the patient is aware enough to change that medication him or herself.”
Andrea Wood, Good Value Pharmacy pharmacist and packaging center manager, said the pharmacy’s master list of customer medications is key to the success of PACT.
“If a hospital calls asking for this list, I’m going to fax it,” she said. “Communication with the hospital (prevents) doubling doses which unfortunately is what happens (when patients aren’t taking medications properly),” Wood said.
“We have that conversation to make sure the patient is going to take his or her medications correctly,” Alex Berce said.
Although the study focused on Medicare and Medicaid patients, PACT protocols have made significant improvements for pharmacy consumers in long term care situations as well, according to Alex Berce.
This seems to be the right recipe for success, according to article findings and coalition representatives.
According to the pharmacy journal article, “(This trial) was positively associated with increased adherence, decreased readmissions, emergency room visits and costs.”
The study concluded by saying, “Community pharmacies should consider instituting PACT or similar programs in their own practices.”
“We are proud of this community; we have one of highest rates of improvement in the state,” Sampson said. “That’s everyone pitching in and doing their part.”