Patient Characteristics Predicting the Frequency of Medication Therapy Management Visits for Patients With Diabetes

Background: Patient characteristics associated with a higher exposure to medication therapy management (MTM) and the relationship between frequency of MTM visits and meeting clinically defined goals of therapy have not been documented. Objective: The goal of this study was to evaluate factors predicting frequency of MTM visits for patients with diabetes and the impact of these visits on diabetes clinical outcomes. Methods: All patients with diabetes participating in a 2007 MTM demonstration project (N = 121) were included in the analysis. A negative binomial regression controlling for age, sex, presence of diabetes complications, taking insulin, Charlson score Index, and hypertension and cholesterol medication regimen composition was used to assess predictors of the number of MTM visits. Optimal diabetes management differences between the 2 groups defined according to median number of MTM visits (low frequency, ≤4; high frequency, >4) was compared by using Wilcoxon Mann-Whitney and χ² tests. Results: Having diabetes complications (relative risk = 2.83 [95% CI, 1.3-6.17]; P = 0.0088) and taking insulin (relative risk = 1.43 [95% CI, 1.12-1.83]; P = 0.0038) were associated with a higher number of MTM visits. At baseline, the high-frequency group had a significantly higher proportion of patients with insulin therapy (P < 0.01), higher proportion with diabetes complications (P = 0.07), and higher mean Charlson score (P = 0.08). The rate of optimal diabetes care was significantly lower in the high-frequency group before MTM (P = 0.02) but not statistically different from the low-frequency group during and 1 year after the demonstration project. Conclusions: Patients with diabetes complications and using regimens that include insulin received more frequent MTM visits. MTM services delivered to a diabetes population with more complex disease or taking insulin have a positive impact on optimal diabetes care.