Managing drug-related morbidity and mortality in the patient-centered medical home

Med Care. 2012 Nov;50(11):997-1001. doi: 10.1097/MLR.0b013e31826ecf9a.


Background: The appropriate use of medications can influence quality performance measures and costs. Drug-related morbidity and mortality represents a public health challenge due to the ineffective and unsafe consequences of medication use. This article addresses the impact of team-based care that incorporates comprehensive medication therapy management on per capita expenditures, quality performance measures, and resolution of drug therapy problems.

Methods: A team-based medication therapy management system developed over 13 years in an integrated health system in 4 Minnesota innovation clinic sites was assessed in terms of: (1) differences in total median health expenditures compared with noninnovation clinics, (2) improvements on 5 performance benchmarks for patients with diabetes in comparison with statewide results, and (3) resolution of drug therapy problems.

Results: Spending growth was 11% less in innovation clinics than that in 38 noninnovation clinics. Median per member per month health care costs measured at 5 intervals over a 15-month period were significantly lower in innovation than in noninnovation sites (P=0.05). Forty percent of patients with diabetes in the innovation clinics achieved all 5 performance benchmark treatment goals in 2009, with a range from 34% to 45%, compared with the statewide result of 17.5% of patients achieving all 5 benchmarks. In addition, over 4000 drug therapy problems were reported to be resolved.

Conclusions: Team-based care helped to achieve quality performance and control spending growth through medication therapy management in a patient-centered medical home innovation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benchmarking / statistics & numerical data
  • Diabetes Mellitus / therapy
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Medication Therapy Management / economics
  • Medication Therapy Management / organization & administration*
  • Medication Therapy Management / statistics & numerical data
  • Morbidity*
  • Mortality*
  • Patient Care Team / organization & administration
  • Patient-Centered Care / economics
  • Patient-Centered Care / organization & administration*
  • Patient-Centered Care / statistics & numerical data
  • Quality Improvement / organization & administration
  • Quality Improvement / statistics & numerical data