Development and validation of a systematic process for expansion of clinical pharmacy activities for comprehensive medication management in primary care within the Department of Veterans Affairs

Abstract

Medication misadventures can be considered either misuse, underuse, or overuse of medication therapy. With over 80% of Americans taking at least one medication per week and an increased percentage of hospital readmissions associated with a medication‐related problem, a strategy must be integrated that can ensure medications are optimized. Comprehensive medication management (CMM) is a patient‐centered process for ensuring medication optimization and improving patient health outcomes that is delivered by a clinical pharmacist working in collaboration with the patient and other health care providers. The Department of Veterans Affairs (VA) is the largest integrated health care system in the United States and has strong clinical pharmacy practice in primary care. In an effort to increase the practice of the clinical pharmacy specialist delivering CMM, we outline a national implementation program conducted by the VA Pharmacy Benefits Management Services Clinical Pharmacy Practice Office to evaluate individual facility quality care needs, matched clinical pharmacist training needs, and the overall impact achieved with clinical pharmacist expansion of CMM.

Comprehensive Medication Management Services with a Holistic Point of View, a Scoping Review

“…The implementation of CMM has spread to a large number of health institutions in the United States [ 10 , 11 ], in Canada [ 12 ] and Spain [ 13 , 14 ]. Within Latin America, Brazil [ 15 , 16 ] stands out for its early CMM implementation.…”

A coordinated approach for managing polypharmacy among children with medical complexity: rationale and design of the Pediatric Medication Therapy Management (pMTM) randomized controlled trial

“…Pharmacists may provide targeted reactive pharmaceutical care in the existing model, but proactive comprehensive care is needed [ 42 , 46 - 49 ]. Pediatric pharmacy specialists currently provide support in multiple hospital settings, but pediatric pharmacists are infrequently incorporated into outpatient models of care for CMC [ 32 , 42 , 46 , 47 , 50 ]. However, a more central role has been proposed for outpatient pediatric pharmacists in the medical home to coordinate and manage medication regimens, and to support primary care providers (PCPs) [ 33 , 48 , 51 ].…”