The profession of pharmacy is facing a shifting health system context that holds both opportunity and risk. If the profession of pharmacy is to advance, pharmacists must be recognized as a consistent member of the health care team in all clinical settings, contributing at the fullest extent of licensure and education. One part of achieving this broad goal is to implement a new way of defining and assessing pharmacy practice skills, such as entrustable professional activities (EPA). Assessment of professional tasks and practice activities with EPAs has been successfully implemented in medical education for assessing trainee preparation for practice. This EPA model is being applied to pharmacy education to develop an assessment framework across the advanced pharmacy practice experience (APPE) curriculum. The APPE course directors, practice faculty members, and the Office of Experiential Education collaboratively defined a set of universal EPAs critical for pharmacists in any practice setting and would be assessed in all practice experience types.

Objective To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing hospitalizations among home health patients. Setting Forty randomly selected, geographically diverse home health care centers in the United States. Design Two-stage, randomized, controlled trial with 60-day follow-up. All Medicare-insured home health care patients were eligible to participate. Twenty-eight consecutive patients within each care center were recruited and randomized to usual care or MTM intervention. The MTM intervention consisted of the following: (1) initial phone call by a pharmacy technician to verify active medications; (2) pharmacist-provided medication regimen review by telephone; and (3) follow-up pharmacist phone calls at day seven and as needed for 30 days. The primary outcome was 60-day all-cause hospitalization. Data Collection Data were collected from in-home nursing assessments using the OASIS-C. Multivariate logistic regression modeled the effect of the MTM intervention on the probability of hospitalization while adjusting for patients’ baseline risk of hospitalization, number of medications taken daily, and other OASIS-C data elements. Principal Findings A total of 895 patients (intervention n = 415, control n = 480) were block-randomized to the intervention or usual care. There was no significant difference in the 60-day probability of hospitalization between the MTM intervention and control groups (Adjusted OR: 1.26, 95 percent CI: 0.89–1.77, p = .19). For patients within the lowest baseline risk quartile (n = 232), the intervention group was three times more likely to remain out of the hospital at 60 days (Adjusted OR: 3.79, 95 percent CI: 1.35–10.57, p = .01) compared to the usual care group. Conclusions This MTM intervention may not be effective for all home health patients; however, for those patients with the lowest-risk profile, the MTM intervention prevented patients from being hospitalized at 60 days.

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Background Significant attention has been given to developing a consistent patient care process for providing comprehensive medication management (CMM). However, little research exists that examines the structures required to effectively manage a CMM practice to achieve quality, consistency and sustainability. Objective The objective of this research was to create a CMM practice management assessment tool to identify and prioritize areas of CMM practice improvement. Methods Thirty‐four pharmacists providing CMM from 35 primary care clinics across five states were divided into three cohorts. Semi‐structured interviews were conducted with pharmacists from Cohort 1. Participants were asked to describe the essential components of CMM practice management and to detail the characteristics of these components in their practice. Themes were identified by two investigators and a descriptive practice assessment tool was developed from emergent themes. Using cognitive interviewing, participants in Cohorts 2 and 3 completed sections of the tool while verbalizing their thought process and providing feedback. This process led to simultaneous development and refinement of the tool, as well as developing evidence of content validity. Throughout tool development, a series of four focus groups with managers overseeing pharmacists providing CMM occurred to obtain their perspectives and feedback on the tool. Results A tool with five domains was developed. Each domain consists of two to three essential components of CMM practice management for a total of 13 components. Each component contains several questions which collectively form a 78‐item descriptive practice management assessment tool. Conclusion A descriptive practice management assessment tool was developed that can be used to aid in CMM practice advancement. This tool can provide direction for quality improvement work as pharmacists and managers seek to make their practices more efficient and sustainable.

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