Abstract:Support for this study was provided to Wilson by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number ULI TR001860. The content of this article is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. The authors have nothing additional to disclose.
“…The data analyzed in this study demonstrates that clinical pharmacists can have positive impacts on patients with diabetes in the primary care setting of a rural healthcare clinic. The improvement in the outcomes of goal attainment rates and decreases in hemoglobin A1c and blood pressure are consistent with findings in other studies [ 2 , 3 , 4 , 5 , 6 ]. The improvement in the primary outcome was statistically and clinically significant.…”
Section: Discussionsupporting
confidence: 91%
“…Without the control group, it can still be inferred that the clinical pharmacy service has had positive impacts on patient outcomes as evidenced by the pre- and post-improvements in chronic disease state outcomes. Other studies have included the use of a control group and have reported improved outcomes in the group that includes a pharmacist [ 6 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Although this current study does not include a control group, the improvements in goal attainment and decreases in hemoglobin A1c and blood pressure are consistent with the findings from the other studies.…”
Section: Discussionmentioning
confidence: 99%
“…Ambulatory care pharmacy services can be implemented in a variety of practice settings, including primary care, specialty care, or telehealth clinics. While there is a plethora of evidence that supports ambulatory care pharmacy in each of these settings, the benefit of a clinical pharmacist integrated into a primary care clinic is particularly well documented [ 2 , 3 , 4 , 5 , 6 ]. Although there are varying practices, comprehensive medication management (CMM) is becoming a prominent model for pharmacists embedded in primary care clinics [ 7 ].…”
Two clinical pharmacy faculty members from a college of pharmacy provide comprehensive medication management in a rural family medicine clinic. The data was assessed for patients with diabetes managed by the pharmacists from 1 January 2017 through to 31 December 2019 to determine the service’s impact on patient outcomes. The primary outcome of this study is the change in the goal attainment rates of the three clinical goals of hemoglobin A1c, blood pressure, and appropriate statin therapy after pharmacist intervention. A total of 207 patients were included. At baseline, the patients had an average of 1.13 of the three goals met, improving to an average of 2.02 goals met after pharmacist intervention (p < 0.001). At baseline, 4.8% of the patients had met all three clinical goals, improving to 30.9% after pharmacist intervention (p < 0.001). There were significant improvements for the individual goal attainment rates of hemoglobin A1c (24.15% vs. 51.21%, p < 0.001), blood pressure (42.51% vs. 85.51%, p < 0.001), and appropriate statin therapy (45.89% vs. 65.70%, p < 0.001). This data adds to the evidence supporting the integration of clinical pharmacists into primary care clinics to improve patient outcomes related to diabetes.
“…The data analyzed in this study demonstrates that clinical pharmacists can have positive impacts on patients with diabetes in the primary care setting of a rural healthcare clinic. The improvement in the outcomes of goal attainment rates and decreases in hemoglobin A1c and blood pressure are consistent with findings in other studies [ 2 , 3 , 4 , 5 , 6 ]. The improvement in the primary outcome was statistically and clinically significant.…”
Section: Discussionsupporting
confidence: 91%
“…Without the control group, it can still be inferred that the clinical pharmacy service has had positive impacts on patient outcomes as evidenced by the pre- and post-improvements in chronic disease state outcomes. Other studies have included the use of a control group and have reported improved outcomes in the group that includes a pharmacist [ 6 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Although this current study does not include a control group, the improvements in goal attainment and decreases in hemoglobin A1c and blood pressure are consistent with the findings from the other studies.…”
Section: Discussionmentioning
confidence: 99%
“…Ambulatory care pharmacy services can be implemented in a variety of practice settings, including primary care, specialty care, or telehealth clinics. While there is a plethora of evidence that supports ambulatory care pharmacy in each of these settings, the benefit of a clinical pharmacist integrated into a primary care clinic is particularly well documented [ 2 , 3 , 4 , 5 , 6 ]. Although there are varying practices, comprehensive medication management (CMM) is becoming a prominent model for pharmacists embedded in primary care clinics [ 7 ].…”
Two clinical pharmacy faculty members from a college of pharmacy provide comprehensive medication management in a rural family medicine clinic. The data was assessed for patients with diabetes managed by the pharmacists from 1 January 2017 through to 31 December 2019 to determine the service’s impact on patient outcomes. The primary outcome of this study is the change in the goal attainment rates of the three clinical goals of hemoglobin A1c, blood pressure, and appropriate statin therapy after pharmacist intervention. A total of 207 patients were included. At baseline, the patients had an average of 1.13 of the three goals met, improving to an average of 2.02 goals met after pharmacist intervention (p < 0.001). At baseline, 4.8% of the patients had met all three clinical goals, improving to 30.9% after pharmacist intervention (p < 0.001). There were significant improvements for the individual goal attainment rates of hemoglobin A1c (24.15% vs. 51.21%, p < 0.001), blood pressure (42.51% vs. 85.51%, p < 0.001), and appropriate statin therapy (45.89% vs. 65.70%, p < 0.001). This data adds to the evidence supporting the integration of clinical pharmacists into primary care clinics to improve patient outcomes related to diabetes.
“…The United States incurs more than $500 billion in avoidable costs every year due to medication‐related morbidity and mortality . An approach to improve patient outcomes and mitigate the avoidable costs caused by suboptimal medication use is comprehensive medication management (CMM) . CMM is a patient‐centered practice that:Ensures each patient's medications (whether they are prescription, nonprescription, alternative, traditional, vitamins, or nutritional supplements) are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended …”
Section: Introductionmentioning
confidence: 99%
“…1 An approach to improve patient outcomes and mitigate the avoidable costs caused by suboptimal medication use is comprehensive medication management (CMM). [2][3][4][5] CMM is a patient-centered practice that:…”
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.
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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
