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Avoiding Medication-Related Problems


An 83-year-old female was referred to Mosaic to reduce the side effects of her current medication regimen and improve her adherence to treatment. The member’s medical history includes diabetes, hypertension, hyperlipidemia, hepatitis C, hepatic neurology, and gout. In total, the member was taking 16 prescribed and over-the-counter medications for these conditions.

Therapy problems that were identified during the virtual home visit included: hypoglycemia, with morning blood sugars running under 80; insomnia; and adverse drug reactions including swelling feet and increased falls due to a high dose of Gabapentin.

In addition, the member’s current pharmacy took 4 weeks to get prior authorization for Harvoni, which resulted in a therapy gap and cost the health plan $33,000 due to the lapse in therapy. Lastly, Mosaic’s Therapeutic Decision Support revealed the member was not adherent to her Jardiance  (diabetes) medication.


Following the clinical review, a Mosaic pharmacist coordinated with the member’s providers to achieve an optimal blood sugar regimen, reduce the member’s fall risk, and lower the chance of a lapse in therapy with the member’s hepatitis C medication (Harvoni).  The following interventions were conducted:


Provider communication and recommendations made to change patient’s medication regimen resulted in improved blood sugar levels and increased adherence. Outcomes include the following:

Feedback from the member’s provider:

“Where have you been? These pharmacies don’t understand the importance of getting medications to a patient on time.”