Therapeutic duplication (TD) can occur when two doctors are prescribing medications for the same patient. It can also occur when a doctor changes from one medication to another within the same therapeutic class, but the patient doesn't discontinue the first medication. In either situation, the individual may end up taking two drugs with similar actions unnecessarily, which could lead to serious side effects.
According to the publication, Age and Ageing, patients who had greater numbers of medications in the home were more likely to have therapeutic duplication. The condition is considered a risk factor associated with poor health outcomes.
Aetna uses its claim system to help identify members who may be at risk of therapeutic duplication for specific medications and provides an alert to the pharmacist that a TD may be occurring. In those instances, their pharmacist may ask about the medications they are supposed to take. The pharmacist can then help determine whether both medications are necessary or whether one of the medications should be discontinued. Generally, individuals usually do not need two drugs from the same category to treat a medical condition.
"We need to remind people that medication errors pose a serious risk and can result in visits to the hospital or ER," said Mark Rubino, Chief Pharmacy Officer, Aetna Pharmacy Management. "The results we've seen with this program are proving that we are helping pharmacists and doctors protect members' safety while helping to reduce medical costs."
Results showed over 4,800 incidents of possible therapeutic duplication were identified among Aetna members in the statin class. Of those, pharmacists avoided filling 3,500 duplicate prescriptions. By providing a participating pharmacists' with broader access to safety information in real-time, Aetna can help pharmacists stop a potentially unnecessary or dangerous duplication before a prescription is filled.
Statins have been associated with serious adverse reactions including elevated liver enzymes and rhabdomyolysis, a serious condition that can lead to acute kidney failure. These effects are more likely with high medication doses and increased serum statin concentrations.
Given the success of the program, Aetna expanded the therapeutic duplication program to include the following drug classes:
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