Study: Medicare Beneficiaries Visit Pharmacies Much More Often than Primary Care Offices

Among more than 681,000 active Medicare beneficiaries evaluated in a nationwide study, investigators found that the median number of visits to community pharmacies was significantly higher than encounters with primary care physicians, suggesting that community pharmacists have frequent opportunities to deliver preventive care and chronic disease management services.

The investigators noted that the shift toward value-based care has placed a greater emphasis on preventive care and chronic disease management services as delivered by multidisciplinary health care teams. Their findings demonstrate that the inclusion of pharmacists in these teams is vital to ensure frequent monitoring and interventions when necessary, according to the study authors.

Beyond medication management services, pharmacists routinely offer preventive care services, including administering vaccinations and identifying patients at high risk for certain diseases. Other studies have shown that pharmacists have positive effects on patients and medication outcomes when contributing to the management of chronic diseases, including diabetes, hypertension, hyperlipidemia, asthma, and depression.

The study analyzed a 5% random sample of 2016 Medicare beneficiaries who were continuously enrolled and had at least 1 pharmacy claim and 1 encounter with a primary care physician. Patients were excluded if they were not continuously enrolled in Part D until death, if they had Part B skilled nursing claims, and if they had Part D mail-order pharmacy claims.

Of the 681,456 patients enrolled, the mean age was 72 years, 61.4% were women and 38.6% men; 82.2% were white, 9.6% were Black, 2.4% were Hispanic, and 5.7% were other races or ethnicities.

In the time period studied, visits to the community pharmacy outnumbered encounters with primary care physicians, averaging 13 and 7, respectively. This held true for all subgroups, except for those with acute myocardial infarction, who averaged 15 pharmacy visits and 14 primary care physician interactions.

The investigators found that the difference in the number of pharmacy and primary care physician encounters was greater in rural areas than in more metropolitan areas. They added that in all 50 states and in all but 9 counties, the number of community pharmacy visits was larger than the number of encounters with primary care physicians.

Based on these findings, the researchers said that community pharmacists are accessible health care providers with frequent opportunities to interact directly with patients. They concluded that primary care physicians should work closely with community pharmacists, who can assist in the delivery of preventive care and chronic disease management.

REFERENCE

Berenbrok L, Gabriel N, Coley K, et al. Evaluation of Frequency of Encounters With Primary Care Physcians vs. Visits to Community Pharmacies Among Medicare Beneficiaries. JAMA Netw Open. 2020;3(7):e209132. Accessed July 31, 2020.