Objective: Evaluate and compare the number and types of medication and non-medication-related interventions by clinical pharmacists and nonpharmacists conducting an Annual Medicare Wellness Visit (MWV).
Design: Multi-center, retrospective case-control study.
Setting: Two community primary care internal medicine clinics in urban Maryland.
Participants: Patients who had a MWV performed January 2014 through October 2015.
Intervention: Pharmacists conducted required components of a MWV and addressed medication or non-medication-related concerns identified while completing the patient health risk assessment.
Main outcome measure: Number and types of medication-related interventions identified by clinical pharmacists compared with nonpharmacists completing the MWV.
Results: Patients in the pharmacist-led MWV group more often had medication-related interventions than those in the nonpharmacist group (median 2 vs. 0, respectively; P < 0.00001). Pharmacists tended to identify at least 1 to 2 medication interventions for each patient (30.4% and 34.8%, respectively), and nonpharmacists often did not intervene on medications (62.79% of the time). There were 37 medication-related interventions made by the pharmacist group in a cohort of 23 patients, and 20 medication-related interventions by the nonpharmacist group in a cohort of 43 patients. The pharmacist group most often addressed medication without indication (17 occurrences) followed by nonadherence (6 occurrences). Providers in the nonpharmacist group most often recognized subtherapeutic dosage (7 occurrences) and indication without medication (5 occurrences).
Conclusions: Pharmacists completing the MWV had a higher rate of medication-related and non-medication-related interventions than the nonpharmacist group. Pharmacist-led MWVs may lead to more appropriate medication use in elderly patients and serve as a financially sustainable care model to provide clinical pharmacy services in the outpatient setting.