Coordinated care improves treatment

According to a study released by the Reston, VA-based National Pharmaceutical Council, coordinated pharmaceutical therapy offers improved treatment outcomes and increased total cost savings compared with component-based management of pharmaceuticals, especially when treating elderly and chronic care patients.

The study cited five "best-case" examples of coordinated pharmaceutical care. These five approaches might, with appropriate modifications, be applicable at other care sites, and could represent a blueprint for organizations that wish to implement coordinated pharmaceutical care.

Ten principles

Each of the programs cited demonstrated an understanding and adherence to the following ten basic principles of coordinated care:

•Â Commitment, leadership and support for coordinated care from upper management.

•Â Alignment of financial incentives and clinical goals across sites of care and service sectors.

•Â Management by interdisciplinary teams of physicians, pharmacists and other care providers.

•Â Centralized responsibility and accountability for the totality of pharmaceutical care for the individual.

•Â A system for identifying patients at high risk for undiagnosed disease and suboptimal therapy.

•Â Ongoing assessment of drug regimens and proper prescribing and use of drugs.

•Â Centralized knowledge of the patient's full medical history and all currently prescribed medications.

•Â Effective communication and feedback among care providers - especially across sites of care.

•Â Education and involvement of the patient in the treatment plan.

•Â Evaluation of the effectiveness of coordinated care programs.

"Innovative programs … are especially important because elderly and chronic care patients account for a disproportionate share of health spending, including pharmaceuticals," said Patricia Adams, vice president for external affairs at the National Pharmaceutical Council. "They have increased risk for adverse consequences because they usually suffer from multiple conditions, are in a weakened physical state and risk conflicting prescriptions from a barrage of specialists." PR