Pharmacist Perspectives on Medication Costs and Affordability: A Pilot Study

Background- Research on pharmacist provided care and services has rarely focused on medication cost and affordability. This study aims to bridge the gap by examining pharmacists' perspectives of medication costs and affordability. Objective- To explore pharmacists' perceptions about medication cost burden for patients, their communication with patients about i) ability to afford medications, ii) price, and iii) ways to reduce medication cost burden, their perceptions about ways to help improve affordability of medications and the barriers to communication. Method- A cross sectional exploratory study design was utilized. A convenience sample of pharmacists working in community pharmacies in Brooklyn was approached and asked to complete a survey. The survey questions examined the extent to which pharmacists: 1) perceived medication cost to be a burden, 2) initiated discussion about i) ability to afford medications, ii) price of medications, iii) ways to reduce cost burden. Pharmacists were also asked to opine on how to improve affordability of medications and their perceived barriers for such communication with the patients. Questions were formulated to differentiate pharmacists' perceptions and behaviors in regards to dealing with patients with (PWI) and without insurance (PWOI). Data was analyzed using SPSS version 17.0. Result- A total of twenty-six pharmacists out of 54 approached participated in the study. Majority of the pharmacists reported the cost of medication to be extremely/very burdensome for PWOI (73%) than PWI (23%). In contrast, more pharmacists reported initiating a discussion very often/always about affordability with PWI (35%) than PWOI (20%). Discussions about price of medications were more common than discussions about affordability and ways to reduce medication burden. On an average, 33% of the pharmacists suggested generics as a way to improve affordability of the medications for PWI and PWOI. Conclusion- Patient-pharmacist communication on affordability and ways to reduce cost burden occurs very infrequently. Understanding the perspectives on patient-pharmacist communication on medication cost may help in developing effective strategies and may help reduce cost-related medication non-adherence.   Type: Student Projec

Evaluation of Early Versus Late Postdischarge Medication Reconciliation on Readmission Rates and Emergency Department Visits.

BACKGROUND: The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions. OBJECTIVE: The purpose of this study is to evaluate the impact of early (hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use. METHODS: In this retrospective study, data for patients who had a clinic visit with a primary care provider (PCP), clinical pharmacist, or both for postdischarge medication reconciliation were reviewed. Primary outcome included hospital use rate at 30 days. Secondary outcomes included hospital use rate at 90 days and hospital use rate with a postdischarge PCP follow-up visit, clinical pharmacist, or both at 30 days. RESULTS: One hundred sixty patients were included in the analysis: 31 early group patients and 129 late group patients. There was no significant difference on hospital use at 30 days in patients who received early or late groups (32.3% vs 21.8%, P = .947). There was also no significant difference on hospital use at 90 days in patients in early versus late group (51.6% vs 50.3%, P = .842). The type of provider (PCP vs pharmacists) conducting postdischarge medication reconciliation did not show significance on hospital use at 30 days (19.9% vs 21.4%, P = .731). CONCLUSION: Results from this study suggest patients can be seen up to 14 days postdischarge for medication reconciliation with no significant difference on hospital use