Design and implementation of a targeted approach for pharmacist-mediated medication management at care transitions

Ploenzke, Chris; Kemp, Tessa; Naidl, Todd; Marraffa, Rebecca; Bolduc, Jennifer

doi:10.1016/j.japh.2016.01.009

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…ADRs, needs additional drug therapy, and dosage too low were the most addressed DTPs. Mining the literature showed a varied range of acceptance rate from 50–55% [ 10 , 52 ] through 70–90% [ 14 , 53 , 54 ] to 100% [ 35 ]. This relatively high acceptance rate reported in the present study might be related to the presence of many comorbidities, complications, and associated polypharmacy that called for teamwork to better manage these conditions.…”

Section: Discussionmentioning

confidence: 99%

Impact of medication therapy management service on selected clinical and humanistic outcomes in the ambulatory diabetes patients of Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia

et al. 2021

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Background Diabetes mellitus (DM) patients are at increased risk of developing drug therapy problems (DTPs). The patients had a variety of comorbidities and complications, and they were given multiple medications. Medication therapy management (MTM) is a distinct service or group of services that optimize therapeutic outcomes for individual patients. The study assessed the impact of provision of MTM service on selected clinical and humanistic outcomes of diabetes patients at the diabetes mellitus clinic of Tikur Anbessa Specialized Hospital (TASH). Methods A pre-post interventional study design was carried out at DM clinic from July 2018 to April 2019. The intervention package included identifying and resolving drug therapy problems, counseling patients in person at the clinic or through telephone calls, and providing educational materials for six months. This was followed by four months of post-intervention assessment of clinical outcomes, DTPs, and treatment satisfaction. The interventions were provided by pharmacist in collaboration with physician and nurse. The study included all adult patients who had been diagnosed for diabetes (both type I & II) and had been taking anti-diabetes medications for at least three months. Patients with gestational diabetes, those who decided to change their follow-up clinic, and those who refused to participate in the study were excluded. Data were analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics, t-test, and logistic regressions were performed for data analyses. Results Of the 423 enrolled patients, 409 fulfilled the criteria and included in the final data analysis. The intervention showed a decrease in average hemoglobin A1c (HbA1c), fasting blood sugar (FBS), and systolic blood pressure (SBP) by 0.92%, 25.04 mg/dl, and 6.62 mmHg, respectively (p<0.05). The prevalence of DTPs in the pre- and post-intervention of MTM services was found to be 72.9% and 26.2%, respectively (p<0.001). The overall mean score of treatment satisfaction was 90.1(SD, 11.04). Diabetes patients of age below 40 years (92.84 (SD, 9.54)), type-I DM (93.04 (SD, 9.75)) & being on one medication regimen (93.13(SD, 9.17)) had higher satisfaction score (p<0.05). Conclusion Provision of MTM service had a potential to reduce DTPs, improve the clinical parameters, and treatment satisfaction in the post-intervention compared to the pre-intervention phase.

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Section: Discussionmentioning

confidence: 99%

Impact of medication therapy management service on selected clinical and humanistic outcomes in the ambulatory diabetes patients of Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia

et al. 2021

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“…Such programs have been shown to help simplify drug regimens, reduce the likelihood of medication-related problems and drug discrepancies at care transitions, and improve medication safety. 34,35 In addition, caregivers that report higher difficulties with medication-related information are more likely to perceive such services to be helpful and are more willing to use them. 36…”

Section: Discussionmentioning

confidence: 99%

Medication management activities performed by informal caregivers of older adults

Look

Stone

2018

Research in Social and Administrative Pharmacy

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Informal caregivers play a vital role in ensuring safe and appropriate medication use by older adults. Medication management is complex and involves many activities that are supported through the use of a variety of tools and strategies that have been adapted and individualized to each specific caregiving scenario. Caregivers should be an important component of interventions that aim to improve medication use among older adults.

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“…[32][33][34][35][36][37][38] To normalize this rate, many studies have reported the average number of discrepancies per patient, though this has also varied. 32,[34][35][36]39,40 Several medication discrepancy classification systems have also been used. 32,[34][35][36][37][38]40 In these reports, certain patient demographics and comorbidities correlated with higher rates of medication discrepancies.…”

Section: Satisfaction Amentioning

confidence: 99%

“…Initial visit intervals for medication reconciliation ranged from 2 to 21 days after hospital discharge. 32,[37][38][39] Research is limited regarding TOC services originating in community pharmacy settings. 34,35,38,40 One community pharmacy-based service identified and resolved an average of four medication discrepancies per patient after hospital discharge through an employerprovided service.…”

Section: Satisfaction Amentioning

confidence: 99%

Quality measures of clinical pharmacy services during transitions of care

King

Burkhardt

Rafferty

et al. 2021

J Am Coll Clin Pharm

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The impact of clinical pharmacy transitions of care (TOC) services on relevant quality measures (QMs) has been a major focus in the recent biomedical literature. The 2020 ACCP Transitions of Care Task Force was charged with updating a 2012 white paper that focused on process indicators of quality clinical pharmacy services during TOC. The Task Force extensively reviewed the recent literature and regulatory measures relevant to TOC services. Given the wide heterogeneity and apparent uncertainty in these measures, the Task Force identified a need to define broader groupings for QMs so that pharmacy TOC services could more be reliably compared across various institutions and practice settings. The Task Force recommends QMs for the processes used to identify, and ultimately resolve, medication discrepancies (QM‐1) and medication therapy problems (MTPs) (QM‐2). Although interventions through various processes can be used to resolve medication discrepancies and MTPs, the findings of these interventions are closely aligned with the major outcomes from these TOC services. Therefore, the Task Force strongly recommends that the successful resolution of medication discrepancies and MTPs be studied for their potential roles as intermediate, or surrogate, QMs (iQM‐1, iQM‐2, respectively) because these are most likely to directly influence or predict quality related to major outcomes from TOC services. In addition, three QMs related to major outcomes are recommended, which are consistent with the triple aim: QM‐3: Health Care Utilization (HCU), QM‐4: Satisfaction and Engagement, and QM‐5: Economics. QM‐3, QM‐4, and QM‐5 span patient‐centered outcomes to institutional, or clinician‐based, outcomes. Specific metrics used for each QM are recommended. In addition to highlighting confounding variables affecting findings in the recent literature, broader contextual considerations that may support TOC services or span multiple practice settings are summarized. Future studies must adopt standard QMs and seek to understand the potential of iQMs to accurately predict success within major patient‐centered and institutional outcomes.

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Design and implementation of a targeted approach for pharmacist-mediated medication management at care transitions

Cited by 17 publications

References 14 publications

Impact of medication therapy management service on selected clinical and humanistic outcomes in the ambulatory diabetes patients of Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia

Impact of medication therapy management service on selected clinical and humanistic outcomes in the ambulatory diabetes patients of Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia

Medication management activities performed by informal caregivers of older adults

Quality measures of clinical pharmacy services during transitions of care

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