Factors affecting Medicare Part D beneficiaries' decision to receive comprehensive medication reviews

Abstract

Objectives: To identify factors influencing Medicare Part D beneficiaries' decision to receive pharmacist-provided comprehensive medication reviews (CMRs) and to evaluate their experiences with pharmacist-provided CMRs.

Design: Cross-sectional descriptive study.

Setting: Beneficiaries living in Maryland or Minnesota, from November 2011 to January 2012.

Participants: Medicare beneficiaries of two Medicare Part D plans who had completed a previous telephone interview for a larger project of medication therapy management quality improvement.

Intervention: Self-reported mail survey.

Main outcome measures: Responses to survey items assessing beneficiaries' perceived importance of proposed factors affecting their decision to receive CMRs and items evaluating patients' experiences with pharmacist-provided CMRs if they had one in the previous year.

Results: The valid response rate was 33.4% (238 of 713). Among the proposed factors, "knowing the out-of-pocket cost" (4.12 ± 1.28 [mean ± SD]) and "conducting in the usual pharmacy" (4.01 ± 1.37) were most important in making a decision to get a CMR. Factors rated significantly more important by those who had versus had not received a CMR included "usual pharmacy," "receiving medication list," "physician's support," and "pharmacists discuss changes with physicians." About one-third (30.6%) of respondents reported having pharmacist-provided CMRs within the previous year. Most respondents believed that having CMRs was important for their health (90.6%) and were satisfied with the results of CMRs (94.7%).

Conclusion: Patients preferred their usual pharmacy or convenient places to have a CMR. Also, a collaborative pharmacist-physician working relationship would be helpful in providing CMRs. Patients who received CMRs expressed a positive attitude toward and satisfaction with pharmacist-provided services.