Over the last decade, pioneering health care organizations have sought tailored approaches to improve health outcomes for individuals with complex health and social needs. However, there are significant gaps in the field, including the issue of medication complexity, a concept encompassing the number of medications an individual is prescribed (polypharmacy), challenges around adherence, risk of medication errors, failure to accomplish treatment goals resulting from inadequate or inappropriate drug regimens, and avoidable complications or harm caused by drug interventions (aka, adverse drug events or ADEs), among others.
The Community Management of Medication Complexity Innovation Lab, led by the Center for Health Care Strategies (CHCS) through support from the Gordon and Betty Moore Foundation, was a national initiative aimed at identifying community-based strategies to improve medication-related outcomes among low-income populations, particularly those with complex health and social needs. The 14-month initiative supported opportunities to:
- Implement community paramedicine efforts to improve medication management, reduce unnecessary utilization, and improve medication-related outcomes;
- Use pharmacy data to create targeted interventions aimed at patients who are taking high-risk medications or complex combinations of medication;
- Repurpose community pharmacies to provide enhanced medication management services such as home visits, health education, and patient education; and
- Tailor and disseminate electronic health record (EHR) medication reconciliation, patient education, and tools to promote safe medication use and adherence.
The Innovation Lab included five competitively selected sites with existing community-based medication management programs for individuals with complex needs. The pilot sites, representing a range of delivery systems and populations, focused on enhancing and expanding programs with a focus on reducing medication errors and improving outcomes. The pilot sites included:
- Northwestern University Health Literacy & Learning Program (HeLP) Lab, Chicago, IL
- Pharmacy Society of Wisconsin, Madison, WI
- ThedaCare Health System, Appleton, WI
- Towncrest Pharmacy, Iowa City, IA
- University of Minnesota College of Pharmacy and Fairview Health Services, Minneapolis, MN
Participants in the multi-site demonstration and evaluation tested new ways to address medication complexity among populations with complex needs. Each pilot site received tailored, expert technical assistance and participated in a peer learning collaborative to exchange and accelerate solutions across sites.