Armando Silva-Almodóvar, Karen Smith, Milap C Nahata
Abstract
Objective: To assess the relationship between patient characteristics and completion of telehealth comprehensive medication reviews (CMRs).
Design: Cross-sectional analysis of a national telehealth medication therapy management program. A negative binomial regression assessed the relationship between number of phone calls to complete a CMR and age, sex, number of medications, poverty level, geographic region, limited English proficiency (LEP), years eligible for CMR services, and if a caregiver completed the CMR.
Setting and participants: Patients included in the analysis were Medicare enrolled, medication therapy management eligible, and completed a CMR in 2017. Patients excluded if they were younger than 65 years, they had incomplete data, they had participated in an employer-sponsored plan, or completed a CMR with their provider.
Outcome measures: Number of phone calls reflected number of outgoing phone calls needed to complete a CMR.
Results: Analysis included 222,163 patients. Females needed 9% more calls to complete a CMR than males (incident rate ratio 1.09 [95% CI 1.08-1.10]). Adults older than 75 years compared with patients between age 65 and 74 years needed 7% fewer calls (0.93 [0.92-0.94]). Patients needing a caregiver to complete the CMR required 33% more calls than individuals who did not (1.33 [1.31-1.35]). Patients eligible for CMR services longer than 1 year required 12%-45% fewer calls to complete a CMR than recently eligible patients. A statistically significant interaction was detected between LEP and poverty quintile.
Conclusions: This study found that poverty level inversely affected the number of phone calls to complete a CMR between those considered LEP and English language-speakers. Female sex and caregiver presence were associated with number of phone calls needed to complete a CMR. Older age and length of CMR eligibility were inversely associated with the number of phone calls needed. Future research is warranted to evaluate whether targeted approaches may improve CMR completion rates.
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