gms | German Medical Science

Background: As part of the outpatient Health Care project in Saxony and Thuringia („Arzneimittelinitiative Sachsen-Thüringen“ (ARMIN)), a structured medication management for participating patients by the supervising doctor and the supervising pharmacist is applied to repeatedly evaluate patient’s drug therapy based on continually recorded medication.

The involved patients support medication management actively during their participation by collecting their (self-)medication in the supervising pharmacy as implemented in the participation agreement. Based on the distribution of prescriptions between supervising and non-supervising pharmacies, the objective of this study is to examine whether there is a supply control towards the supervising pharmacist and the supervising pharmacy.

Materials and methods: A retrospective analysis of drug prescription data from a German statutory health insurance (AOK PLUS) of contributing insured patients was conducted observing the first 15 months of participation and the year before. The study population only included insured persons, who participated in ARMIN for at least 15 months between 01.07.2016 and 30.04.2019. Limited by the data source, over-the-counter-drugs and private-prescribed drugs were not accessible. We evaluated the quantity of involved pharmacies and prescription ratio for supervising and non-supervising physicians and pharmacies in comparison with the previous year.

Results: In the first 3 months, 2562 (78.66%) of the participants, who have at least received one prescription, redeemed their prescriptions only in the supervising pharmacy. This was more than in the same period of the previous year (74.84%) and the following year (77.05%). Within the first 12 months of participation, 88.9% of all prescriptions were received at the supervising pharmacy compared to 84.5% in the year before participation. The prescription ratio within the supervising physicians and pharmacists increased by 3.5% to 67.1%. 5.6% of the prescriptions came from external doctors redeemed in further pharmacies.

Conclusion: This study shows that the guidance by pharmacist & doctor in ARMIN’s medication management is based on and strengthens the supply structure of medication between the participating partners and thus put coordination of medication supply into effort. With the start of participation, fewer pharmacies were involved in the medication supply through implementing the requirement to receive medication in one pharmacy as a contract clause. This led to higher involvement of supervising physician and pharmacist in medication process, which theoretically raises the transparency of drug information for Medication Management. Particularly the participating pharmacy is able to keep the overall medication together and supports the pilot function of the caring doctor. Drug prescriptions of external doctors delivered by other pharmacies represent a potential information gap.