Results

Program evaluation is crucial for Senior PharmAssist. Participant data are collected on an ongoing basis at six-month intervals. The primary focus of the participant evaluation is to assess medication adherence, health services utilization, functional capability and satisfaction. Our first program evaluation, published in the N.C. Medical Journal (March/April 2000), demonstrated that:

  • 31% fewer participants used emergency departments and 29% fewer participants stayed overnight in hospitals after being enrolled in Senior PharmAssist for one year.

A second, more exhaustive examination of outcomes confirmed that after two years in our program, participants report:

  • a 51% decline in the rate of any hospitalizations and 27% reduction in the rate of any emergency department use.

Participants also report improved perceived health and maintain their ability to perform tasks measuring independence, such as bathing, dressing and taking medications on their own. This evaluation was presented at the annual meeting of the American Public Health Association and published in the American Journal of Health-System Pharmacy (Vol. 63 Feb. 15, 2006).

Since this evaluation was published and with the advent of Medicare D (drug benefits), we have expanded Senior PharmAssist services to include Medicare counseling. In addition, our direct financial assistance for medicines now works as secondary coverage; we help lower copayments for medications on our formulary after Medicare drug plans pay. In 2017/18, we worked with colleagues at the UNC Gillings School of Global Public Health to conduct a second evaluation to see if our revised program would lead to similar outcomes – and it did.

This evaluation cannot tell us exactly how each of our services contributes to the overall outcomes. However, we know that as in the 2006 evaluation, the combination of these services has contributed to decreases in both inpatient stays and emergency department use:

1) user-friendly access to medicines on our geriatric formulary

2) medication therapy management with pharmacists trained in geriatrics

3) tailored community referrals

4) comprehensive Medicare counseling

This most recent evaluation is entitled, “Senior PharmAssist: Less Hospital Use with Enrollment in an Innovative Community-Based Program,” and is published in the Journal of the American Geriatrics Society, Volume 66, 2018.

Please let us know if you would like a copy of this article, which is summarized as follows:

Primary outcome measures were self-reported emergency department (ED) visits and hospital admissions, assessed every 6 months for 2 years. We found a significant decrease in the mean number of ED visits (0.83 visits/year to 0.53 visits per year), the percentage of participants reporting ED visits (49% to 31%), and mean hospital admissions (0.56/year to 0.4/year).  These changes represent an overall decrease in hospital use by one third after two years with us.

Our program is uniquely structured in several ways, but primarily in the multi-pronged approach we take with each participant. These outcomes support our belief that treating each participant as a unique individual with specific attributes and  challenges, and serving as an integral part of their healthcare team has a tremendous positive impact.