A mixed methods evaluation of the implementation of pharmacy services within a team-based at-home care program

Blanchard, Carrie; Duboski, Vanessa; Graham, Jove; Webster, Linda; Kern, Melissa; Wright, Eric A.; Gionfriddo, Michael R.

doi:10.1016/j.sapharm.2021.02.017

Cited by 4 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additional work is being conducted exploring the challenges with practicing CMM telephonically. 21 We implemented several study design elements to enhance the validity of our CMM and MTP documentation. Pharmacists involved in completing CMM and conducting MTP documentation were trained in CMM delivery and educated on the use of a standardized note template for use in their MTP documentation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Medication therapy problems identified by pharmacists conducting telephonic comprehensive medication management within a team‐based at‐home care program

Graybill

Duboski²,

Webster

et al. 2021

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

IntroductionComprehensive Medication Management (CMM) is a collaborative patient‐centered approach to medication optimization. We recently implemented telephonic CMM as part of a multidisciplinary team within a team‐based at‐home care program. The objective of this study was to describe the type and frequency of medication therapy problems (MTPs) identified by pharmacists delivering CMM as part of this program, as well as the acceptance rates of the recommendations made to rectify them.MethodsWe conducted a retrospective chart review of all patients receiving CMM within the program between December 12, 2018 and December 31, 2019. We identified and classified MTPs based on the framework developed by the Pharmacy Quality Alliance. Descriptive statistics were used to determine the quantity of MTPs, as well as the acceptance rates of the recommendations.ResultsWe identified 307 patients who received CMM. Of these patients, 58% were female (178/307) and 96% identified as White (296/307). Average age was 72 years old (SD 13). On average, pharmacists identified 4 MTPs/patient with a 35% acceptance rate (431/1228) for their recommendations. Of those accepted, pharmacists were able to resolve 185 (43%) of these MTPs on their own while providers resolved the remaining 246 (57%) MTPs. Acceptance of MTPs was more likely if patients were spoken to (38.4% vs 29.5%, relative risk [RR] = 1.30, 95% CI 1.10‐1.54, P = .002).ConclusionsPharmacists were able to identify several MTPs when conducting telephonic CMM within a team‐based at‐home care program. These MTPs and their associated recommendations however, often failed to be resolved. Recommendations were more likely to be resolved if patients were spoken to, highlighting the importance of engaging the patient as part of CMM. Future studies should examine ways to improve intervention acceptance as well as the clinical and economic impact of changes made as a result of telephonic CMM and MTP identification.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Contrary to these findings however, we were unable to detect a difference in the rates of the individual MTPs identified between patients that were spoken to and those that were not. Additional work is being conducted exploring the challenges with practicing CMM telephonically 21 …”

Section: Discussionmentioning

confidence: 99%

Medication therapy problems identified by pharmacists conducting telephonic comprehensive medication management within a team‐based at‐home care program

Graybill

Duboski²,

Webster

et al. 2021

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

show abstract

“…30 In contrast, a previous review by McFarland et al 35 found high returns on investments and cost savings from various CMM sites through savings in facility costs. Yet, as argued by Blanchard et al, 36 differences in implementation strategies for CMM may account for the heterogeneity of our results.…”

Section: Humanistic Outcomesmentioning

confidence: 62%

“…Graybill et al 29 assert that fidelity to CMM is insufficient unless the patient is spoken to in real‐time, and so only interventions where a complete medical and medication history were reviewed with the patient were included in our review using our screening tool 43 . Clearly designed implementation strategies improve the fidelity to CMM and lack of implementation strategies may lead to heterogenous results 31,36,43 . Thus, we found that out of hundreds of studies that included keywords for CMM and telehealth, only 11 truly reported fidelity to CMM using our screening tool.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive medication management services provided via telehealth or hybrid models: A scoping review

Amundson

Marupuru

Kliethermes

et al. 2022

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Comprehensive medication management (CMM) is increasingly provided by health care teams through telehealth or hybrid modalities. The purpose of this scoping literature review was to assess the published literature and examine the economic, clinical, and humanistic outcomes of CMM services provided by pharmacists via telehealth or hybrid modalities. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.Randomized controlled trials (RCTs) and observational studies were included if they: reported on economic, clinical, or humanistic outcomes; were conducted via telehealth or hybrid modalities; included a pharmacist on their interprofessional team; and evaluated CMM services. The search was conducted between January 1, 2000, and September 28, 2021. The search strategy was adapted for use in Medline

show abstract

“… 32 The model suggests that the successful implementation of an innovation is necessary for it to effectively support development and has been shown to be beneficial in several areas, including the integration of pharmacy services. 32 , 33 Therefore, the aim of this study is to gauge perceptions of the competency-based educational resource package created for GPCP in Scotland through the use of Proctor’s implementation outcomes. This will allow increased understanding of the features underpinning effective implementation of competency-based education.…”

Section: Introductionmentioning

confidence: 99%

Implementation of pharmacist-led services in primary care: A mixed-methods exploration of pharmacists’ perceptions of a national educational resource package

Preston¹,

Weir²,

Mueller³

et al. 2021

Pharm Pract (Granada)

View full text Add to dashboard Cite

Background: To help alleviate the global pressure on primary care, there has been an increase in the number of clinical pharmacists within primary care. Educational resources are necessary to support this workforce and their development within this role. An educational resource package was developed in Scotland to support the General Practice Clinical Pharmacists (GPCPs), containing a hard copy Competency and Capability Framework (CCF), an online platform (TURAS) and both clinical and educational supervisors in 2016. Objective: To examine the implementation of a competency-based educational resource package through the exploration of pharmacists’ perceptions of its adoption, acceptability, appropriateness, and feasibility. Methods: Participants were GPCPs who had been part of a national training event between 2016 and 2018. The participants were given the opportunity to complete an online questionnaire or a semi-structured telephone interview. Both data collection tools were based on Proctor’s model of implementation outcomes: adoption, acceptability, appropriateness and feasibility. Areas covered included GPCPs’ perceptions and level of adoption of the educational resource package developed to support them in their role. Results: Of a potential 164 participants, 52 (31.7%) completed the questionnaire and 12 (7.3%) completed the interview. GPCPs indicated widespread adoption and were accepting of the resources; however, it was suggested that its value was undermined, as it was not associated with a qualification. The appropriateness and feasibility of the resources depended on GPCPs’ individual situation (including current role, previous job experience, time available, support received from peers and supervisors, and perceptions of resources available). Conclusions: The suitability of the CCF was evidenced by participants’ adoption and acceptance of the resource, indicating the necessity of a competence-based framework to support the GPCPs’ role. However, its suitability was hindered in terms of varied perceptions of appropriateness and feasibility. Despite the limited sample size, the results indicate that the value of these resources should be promoted across primary care; nevertheless further facilitation is required to allow GPCPs to fully engage with the resources.

show abstract

A mixed methods evaluation of the implementation of pharmacy services within a team-based at-home care program

Cited by 4 publications

References 31 publications

Medication therapy problems identified by pharmacists conducting telephonic comprehensive medication management within a team‐based at‐home care program

Medication therapy problems identified by pharmacists conducting telephonic comprehensive medication management within a team‐based at‐home care program

Comprehensive medication management services provided via telehealth or hybrid models: A scoping review

Implementation of pharmacist-led services in primary care: A mixed-methods exploration of pharmacists’ perceptions of a national educational resource package

Contact Info

Product

Resources

About