How medication decision support can improve medication optimization and compatibility

Accurate data and comprehensive analysis empower health plans and healthcare providers to advance the safe use of medicines.

Optimizing drug compatibility among health plan participants is not just about trying to screen a long list of potential individual drug interactions using outdated methods. This involves assessing whether an individual’s drug regimen through a comprehensive analysis of simultaneous multiple drug interactions, as well as genetic makeup. By using more modern and advanced tools, we can better assess and mitigate the potential risk of drug-related harms.

The risk stratification systems that many healthcare organizations use assess the likelihood of harm only on diseases. However, people with the same disease may follow different treatment regimens to treat this disease and other conditions. These different drug combinations may pose distinct risks. For example, certain medications can contribute to a prolonged heartbeat, which can be dangerous and even fatal. Knowing exactly what medications a person is taking can help assess and monitor this risk.

An accurate medication list can involve many moving parts. People may receive prescriptions from more than one health care provider, including an internist, cardiologist, endocrinologist, etc. It is essential to incorporate medications from all providers into the comprehensive analysis, as a new prescription may interact with various other medications.

Participant or patient-reported data can shed light on an individual’s level of medication adherence and any mitigating factors driving their behavior (eg, side effects). We know that pharmaceutical systems’ adherence tracking using refill data may not reflect how patients are actually taking their medications. If a person is not fully compliant, a discussion with a clinical pharmacist or health care provider can greatly help them understand their medications. These conversations are grounded in motivational interviewing and educating patients about why certain medications have been prescribed to them and the often long-term benefits.

To help stratify risk, track medications and adherence, and ultimately improve medication optimization, health plans and healthcare providers can take advantage of the tools and services. But not all mediums are the same. The more impactful options provide comprehensive drug reviews that analyze the drugs an individual is actually taking and the interactions that might occur when they work together in the body.

Pharmacogenomic analysis can further enhance drug optimization, as it can help determine how an individual might metabolize different drugs based on their genetic makeup. A study published in the Journal of Palliative Medicine in February used a pharmacogenomic analysis for patients with advanced disease – all of whom were taking at least one opioid and at least four other drugs.

Participating clinicians received pharmacogenomic information, including recommended counseling regarding the potential for multi-drug and drug-gene interactions. In particular, the recommendations specified an interaction, highlighted the potential for change resulting from drug effects, and discussed the way forward (e.g., communicated the importance of monitoring during treatment, suggested dose reduction ). According to the clinicians, more than half of the patients included in the study received one or more treatment changes due to pharmacogenomic information.

Advanced medication decision support can make all the difference in optimizing medication regimens, helping to assess whether the medications an individual is taking are compatible with each other and with the genetic makeup of the patient. ‘individual. Specifically, by stratifying a population to assess risk based on accurate drug lists, using patient-reported adherence data, collectively analyzing potential multi-drug interactions, and using pharmacogenomic analysis, such support can greatly enhance safe medication use among health plan participants. .

Orsula Knowlton, PharmD, MBA, is Founder and President of Tabula Rasa Healthcarea health technology company.

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