Simulating pharmacy operations to increase medication therapy management

Patient safety and medication adherence are critical challenges in healthcare environments that have led to numerous interventions to improve safe and effective use of medicines. One effective intervention is providing Medication Therapy Management (MTM) programs to patients. This research focuses on providing more MTM for patients at community pharmacies in order to improve their medication understanding. The key challenge is that MTM can only be provided by a pharmacist who is responsible for oversight of all dispensing of medications in any community pharmacy. Therefore, a simulation model was built to evaluate different prescription filling strategies that affect pharmacist utilization and these strategies are evaluated with the objectives of minimizing patient waiting time, maximizing the number of patients serviced, and providing as much MTM as possible. A number of important variables are taken into account including patient arrival patterns, staff schedules, and prescription abandonment. Prescription abandonment is something that has become a significant issue with the shift towards electronic prescriptions (the number of e-prescriptions received in community retail pharmacies increased from only 29 million in 2007 to over 9.7 billion in 2015). The simulation model is also used to evaluate the value of obtaining varying degrees of prescription information such as likelihood of abandonment and expected pickup times.