Current and future state of quality metrics and performance indicators in comprehensive medication management for ambulatory care pharmacy practice

Self Cite

Federally Qualified Health Centers (FQHCs) are critical to providing care to underserved populations in the United States. Their focus on interprofessional care has also made FQHCs ideal locations to integrate pharmacists into care teams and advance pharmacy practice. However, despite long-standing involvement by pharmacists, there have been limited attempts to synthesize this literature. We conducted a comprehensive search for published literature on the roles of pharmacists in FQHCs and narrowed our search to 54 manuscripts and abstracts for inclusion in this narrative review. We found that pharmacists in FQHCs are providing care that is interprofessional, multifaceted, and evolving rapidly in response to environmental changes.Pharmacists are routinely involved in the traditional management of chronic disease, such as diabetes, hypertension, behavioral health, and respiratory conditions. In addition, pharmacists have forged roles in preventive care, infectious disease, and pain management. Models include appointment-based approaches; however, there was also heterogeneity in approaches consistent with the dynamic nature of the healthcare system in the United States with engagement in population health, transitions of care, and telehealth, as a few examples. Collaborative practice agreements were used to deliver care in some cases, although this was not commonplace, and reimbursement by third party payers was rarely addressed. Relationships with community pharmacies, often driven by the 340B Drug Pricing Program, were also noted.Recommendations for future research in this area include increasing the rigor of future research by standardizing pharmacy interventions and including comparator groups, a greater focus on financial sustainability, and further exploration of how state laws surrounding pharmacist provider status and scope of practice impact pharmacy service development.

Section: Future Directionssupporting

confidence: 69%

Section: Future Directionsmentioning

confidence: 99%

Pharmacist care in Federally Qualified Health Centers: A narrative review

Rodis

Irwin

Valentino

et al. 2022

Self Cite

“…8 With the exception of the recommended CMM structure and process measure sets, validated measures specific for CMM, especially related to patient outcomes, have yet to be developed. 53 Although the outcomes measures recommended are useful for measuring discrete elements attributable to CMM services, they may fall short in comprehensively measuring the full effects of a CMM program. Thus, they may have reduced utility in assessing CMM value only to those who have the condition or use a particular medication.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive medication management: Review and recommendations for quality measures

Haas

Kliethermes

Armistead

et al. 2023

Self Cite

Comprehensive medication management (CMM) provided by a clinical pharmacist can improve the quality of care and reduce health care costs through the optimization of medication use and a significant reduction in medication‐related problems. As demonstrated by multiple research studies and detailed in published use cases, CMM should be an essential practice for improving population health. This narrative review discusses the limitations of the current evidence and recommends structure, process, and outcome measures to ensure that the key elements of CMM that drive the observed benefits are implemented with fidelity to address the goals of the quadruple aim. The proposed outcome measures are further sub‐classified into economic, clinical, and humanistic categories. Several medication‐related measures are recommended to help define the importance and value of CMM as a key component of population health management.

“…It is important to acknowledge that the growth and development of pharmacist‐to‐pharmacist collaborative practices in these early stages contribute to the heterogeneity of outcomes. Clinicians and teams of collaborators can look to guidance documents/tools for proposed quality metrics to guide future design for alignment around key outcomes 46 …”

Section: Discussionmentioning

confidence: 99%

“…Clinicians and teams of collaborators can look to guidance documents/tools for proposed quality metrics to guide future design for alignment around key outcomes. 46…”

Section: Discussionmentioning

confidence: 99%

Collaboration between pharmacists in community pharmacy and ambulatory clinic settings: Current state and future directions

Cochran¹,

McGivney²,

DiBridge³

et al. 2023

Pharmacists in the community and ambulatory settings are primed for collaboration that can optimize care. Now is the time to capitalize on the momentum and positive disruption of the COVID‐19 pandemic that propelled pharmacists and their organizations to respond with agility to deliver care in new ways, pivot to develop new partnerships, and leverage technology. The growth of collaborative practice agreements within ambulatory care settings, the enhancement of clinically integrated networks, and the growth in professional organization support create an environment ripe for implementation of pharmacist‐to‐pharmacist collaborations. The American College of Clinical Pharmacy 2022 Clinical Practice Affairs B Committee sought out literature, as well as prepublication contemporary examples, demonstrating models of intraprofessional collaboration among pharmacists in community and ambulatory settings. The committee formulated six key recommendations to optimize pharmacist collaborations in the community and ambulatory settings and formed a framework for practical implementation strategies at the levels of individual pharmacists, organizations, and educational institutions and for legislative advocacy.