Prescription and over-the-counter medications are milestone medical advances that impact how we treat and prevent illness. Medication therapies for individuals with behavioral health conditions have become much more prevalent and accepted in the past 10 years. Nonetheless, it is primary care physicians that prescribe the majority of behavioral health medications; overall, 67 percent of psychopharmacologic drugs are prescribed by primary care physicians (Rural Health Advisory Committee, 2005).
As the healthcare community works toward a more holistic approach to patient care, there will be greater opportunity for treatment optimization but also greater burden on medical professionals to navigate the complexities of medication management.
At Netsmart, we believe it is time to redefine the best practice closed-loop medication process and focus on a comprehensive medication management process that spans the continuum of care. This evidence-based, groundbreaking methodology has the potential to bridge the medication management gaps in inpatient and outpatient settings and to ensure clients receive optimal prescriptions and care for both episodic and chronic circumstances.
In the inpatient setting, care delivery is completely dictated and delivered by the clinicians. Since the entire inpatient care process happens within an organization’s four walls — and is solely dependent on the care team establishing a set of policies and procedures, anchored on the clinical EHR – it is a somewhat contained effort. The original five rights is the final check at the point of medication administration. What is administered must match up with the order placed by the physician and depend on the handling and processing of the medication by pharmacy. And additional sixth right, “the right evidence,” takes advantage of available health information technology (HIT) capabilities related to CDS to ensure the clinical assessment and medication orders are optimal.
In the outpatient setting, the client plays a very large role in his/her own treatment course. The care team must look to other ways to achieve the same level of safety and optimal medication therapy as in the inpatient setting. Taking one’s medication is often not as easy as it sounds. Medications have to be taken based on a schedule. The medication can be disagreeable or produce side effects. Client expectations about the benefit and results of taking the medication may not be well understood and impact their willingness to comply. All these factors can be the cause of medication non-adherence. If pills stay in their bottle, are taken inconsistently or inappropriately, this can lead to negative clinical outcomes and rising costs of the healthcare system.
We propose that the care team can leverage its resources and information to drive toward a new “Six Rights” of outpatient medicine management. These are: 1) right prescription, 2) right regimen, 3) right dispense, 4) right knowledge, 5) right coordination, and 6) right result.
Read the full white paper, “Comprehensive Medication Management: Going Beyond 5 Rights To A Person-Centric Model”
Paper is listed under “Medication Management.”