Impact of Comprehensive Medication Reviews on Medicare Beneficiaries With Type 2 Diabetes.

Abstract

Background: Type 2 diabetes (T2DM) management, particularly adherence to oral antidiabetic drugs (OAD), is a key focus of the Part D Medicare Medication Therapy Management (MTM) program. Despite potential benefits, evidence on the effectiveness of MTM, specifically Comprehensive Medication Reviews (CMRs), remains mixed. To evaluate the effectiveness of CMRs on patient outcomes, we conducted the largest CMR evaluation to date among Medicare beneficiaries with T2DM.

Methods: We conducted a retrospective observational study using Medicare claims and MTM data from 2013 to 2019 to examine the impact of CMR on OAD adherence as measured by the proportion of days covered (PDC), statin utilization, emergency department (ED) visits, and hospitalization. A difference-in-difference (DiD) approach with inverse probability treatment weighting was used to reduce confounding.

Results: Although CMR recipients and nonrecipients both experienced a reduction in PDC during the follow-up, CMR recipients experienced 2.4% (95% CI, 1.9%-2.9%) less of a decline than nonrecipients, and 2.0% (95% CI, 1.2%-2.8%) fewer CMR recipients were considered non-adherent after CMR delivery. The proportion of CMR recipients using statin increased 1.4% (95% CI, 0.7%-2.2%) relative to nonrecipients after CMR delivery. The proportion of CMR recipients who experienced an ED visit declined by 0.3% (95% CI, -0.6% to 1.2%) while the proportion of hospitalization increased 1.9% (95% CI, 1.1%-2.8%) following CMR delivery, relative to nonrecipients.

Conclusion: Patients with T2DM receiving a CMR experienced improved OAD adherence and statin utilization compared to nonrecipients. Our results demonstrate the potential benefits of collaborating with pharmacists to improve diabetes care.