Research Spotlight: Meena N. Murugappan

Meena N. Murugappan, PharmD, MPH  Research Associate and SAPh PhD Student

Improving Mental Health—Are Pharmacists an Untapped Resource?

Millions of Americans are impacted by mental illness each year and as many as one in five people will experience mental illness at some point in their life. For patients with mental illness, medications are treatment critical form of treatment. This places pharmacists in a unique position to help patients with mental illness improve their health.

In a recently published study in the Journal of the American Pharmacists Association, Dr. Meena Murugappan, a PhD student in the Social and Administrative Pharmacy program and faculty members Randall Seifert and Joel Farley from the University of Minnesota College of Pharmacy looked at how often pharmacists reviewed medications in patients with mental illness. Using a large Medicare database with more than 7 million Medicare patients, Dr. Murugappan’s team examined the delivery of a Medicare program called medication therapy management or MTM in patients with and without mental health conditions.

“We found that patients with mental health conditions were more medically complex, utilized the hospital and emergency room more often, had more comorbid conditions, used more medications, and were more likely to have a medication therapy problem than patients without mental illness,” says Dr. Murugappan.  “Given this complexity, this group has more to benefit from having a pharmacist review their medications. Unfortunately, this group was less likely to accept the most comprehensive service under MTM called a Comprehensive Medication Review (CMR) when it was offered to them. This is despite our data showing that pharmacists were just as likely to offer this service to patients with mental illness than those without."

Asked to describe the implications of her findings, Dr. Murugappan offered a number of suggestions to pharmacists to help better reach and serve Medicare patients who have mental health conditions. “First, I think it would be helpful to increase awareness that MTM is a covered clinical service available at no cost to most patients. Many patients may not seek MTM because they perceive there to be a cost associated with the service. Second, there is an opportunity for pharmacists to collaborate more closely with a patient’s primary care physician to ensure patients that need the service are referred for the service. I think there are also opportunities to customize the delivery of MTM to meet the needs of patients with mental illness. Mental illness often carries a stigma which may prevent patients who would benefit from MTM, from reaching out and getting this service when they need it.”

This project utilizes a new data source acquired by the Department of Pharmaceutical Care and Health Systems to evaluate the delivery of clinical services by pharmacists. “Although MTM as a program started in 2006, this is the first time data has been made available to researchers to describe all of the MTM services that pharmacists provide. This gives us an opportunity to describe who is getting MTM, how the service is provided to patients, the reach of the program across the US, and how effective the program is at helping patients use their medications safely and appropriately.” said Dr. Farley when asked to describe the data.