Over 80 percent of Americans take at least one medication, nearly 30 percent take five or more. That translates to more than 3.5 billion prescriptions written every year making drugs the third highest health care delivery cost after hospital and physician services - amounting to over $250 billion annually. While the benefits of medication therapy are or can be substantial medication errors are among the most common medical error. According to the IOM an estimated 450,000 preventable adverse drug events (ADEs) occur each year in hospitals and another 800,000 preventable ADEs occur in long term care facilities – though these numbers are believed to be under estimates. According to the CDC fatalities from medication errors in 2010 accounted for 35,000 deaths, or more deaths than caused by auto accidents. Medication harm is so pronounced per the Dartmouth Institute for Health Policy there is nearly a 1:1 ratio of drug spending to spending on unintended mediation harm.
Dr. Isetts begins this 20-minute podcast by noting the importance of rethinking or reframing the problem of medication harm by emphasizing the utility developing a true medication use system, i.e., medication therapy management (MTM) and imbedding MTM into all health care delivery settings. He emphasizes the importance of understanding first why patients do not appropriately follow their medication regimes. He discusses the pluses and minuses of physician computer order entry systems. He defines MTM as primarly insuring patients understand the intended uses for their medications, identifying each patient's goals of therapy and insuring patients understand all relevant drug safety issues. Dr. Issets describes the work that's been done to improve the Medicare drug benefit by aligning it with Medicare hospital and physician care delivery and what can and is being done to reduce drug-related fatalities.
Dr. Brian Isetts is Professor of Pharmaceutical Care and Health Systems at the University of Minnesota. For the past two years he has been a Health Policy Fellow at the Centers for Medicare and Medicaid Services (CMS) working to improve medication adherence. Dr. Isetts' field of expertise concerns studying the outcomes of medication therapy management services (MTMS) provided within the practice of pharmaceutical care. Beyond CMS, Dr. Isetts has worked with the American Medical Association, et al. to ensure MTMS by pharmacists. He was graduated with a BS from the University of Wisconsin School of Pharmacy and with a Ph.D. from the University of Minnesota College of Pharmacy.
Dr. Brian Isetts Discusses Ways to Improve Medication Therapy (April 3, 2013)