Integrating Cost-of-Medication Conversations into Primary Care
Medication costs represent a significant portion of patient out-of-pocket (OOP) costs. Patients wish that their primary care clinicians would discuss ways to reduce their medications with them. Clinicians are willing to do so but are concerned about time. Viable strategies exist for reducing OOP medication costs including generic substitution, class substitution, pill splitting, 90-day prescribing, stopping medications, and referral to social workers, change in insurance and low cost programs.
Embedding brief medication affordability questions, (e.g. Is the cost of any of these medications a burden for you?") into the medication reconciliation process provides a means for nursing staff to screen for OOP medication costs. Training nursing staff in screening and training clinicians in actionable strategies for addressing these OOP medication concerns during visits represents viable strategies for workflow integration. Providing prompts and resources for these steps and strategies will reinforce their integration.
We will recruit five practices and provide them with education, training, and resources. We will adopt rigorous, mixed quantitative and qualitative methods for evaluating our intervention.
The primary objective of this project is to assess the feasibility and impact of a team-based approach to promoting cost-of-medications conversations. Our questions are:
- Can cost-of-medications screening questions be embedded into primary care clinical workflow?
- Can this screening, when supported by clinician and staff training and resources, promote cost-of-medication conversations with patients?
- Will these conversations result in medication cost-reduction?
- What factors will moderate and mediate these effects?
December 2016 – December 2017
Check back for key finding and publications.
For additional information about this study, please contact:
Jen Carroll, MD MPH
AAFP National Research Network
This study is funded by grants from the Robert Wood Johnson Foundation.