The practice management components needed to support comprehensive medication management in primary care clinics

Abstract

Background Practice management (ie, the necessary resources and support to provide comprehensive medication management [CMM] in an efficient and productive manner) is a central part of CMM practice. However, research identifying the key components of CMM practice management was previously lacking. Methods Pharmacists providing CMM from 35 primary care clinics across five states were divided into three cohorts. One‐on‐one semi‐structured interviews were conducted with the lead pharmacist from all clinics in Cohort 1. Participants were asked to describe the essential components of CMM practice management as they applied to their practice. Inductive coding of transcripts led to an initial practice management framework. Participants in Cohorts 2 and 3 reviewed the essential components and participated in individual cognitive interviews. Throughout this process, a series of four focus groups with managers who oversaw pharmacists providing CMM also occurred to obtain their initial perspectives, as well as feedback on the evolving essential components of practice management. Results Thirteen essential components of CMM practice management emerged: leadership support, availability and adequacy of clinic space, billing and revenue systems, methods for identifying patients in need of CMM, scheduling CMM services, care documentation, presence and scope of collaborative practice agreements, interprofessional collaboration, engagement of support staff, measuring CMM data, reporting CMM data and outcomes, quality assurance processes, and practitioner training. These essential components were grouped into five overarching domains: organizational support, care delivery processes, care team engagement, evaluating CMM services, and ensuring consistent and quality care. Conclusion This study defined the essential components of CMM practice management which may be used to guide CMM practice development and advancement.

Development of the comprehensive medication management practice management assessment tool: A resource to assess and prioritize areas for practice improvement

“…A description of participating pharmacists and clinic sites is available in the companion manuscript. 18 Using the responses of the first CMM manager focus group and participants in Cohort 1, an initial version of the practice management tool was drafted. The initial tool included 14 essential components and was comprised of 68 items.…”

“…An additional limitation of both the MI-AMMP and the Ambulatory Care Self-Assessment Tools is that neither tool relied on a robust, evidence-based practice management framework. The CMM PMAT, however, was developed based on a framework for CMM practice management 18,19…”

“…To develop items for the practice management assessment tool, a CMM practice management framework was formed in parallel to tool development. 18,19 To develop the framework, a focus group with the CMM managers was carried out by the lead investigator (DLP) and oneon-one, semi-structured interviews with each of the 12 pharmacists in Cohort 1 were conducted by the lead investigator and a research associate who was also a pharmacist. Interviews and the focus group centered on the essential components of CMM practice management from the participants' perspective.…”

Implementation and evaluation of comprehensive medication management in telehealth practices

“…The CMM practice management assessment tool (CMM PMAT) can help identify infrastructure support needs and capacity. 35,36 Implementation surveys and tools provide valuable baseline information to ensure adequate exploration during the formation of a CMM telehealth program. 12,37…”

How a State Measures Up: Ambulatory Care Pharmacists’ Perception of Practice Management Systems for Comprehensive Medication Management in Utah

“…Efforts to implement CMM through collaboration in UAAP centered on the work of the CMM in Primary Care Research Team [ 11 , 12 ], with the selection of the Practice Management Assessment Tool (PMAT) [ 12 ] as the instrument to determine the current state of practice management systems at the two institutions. The PMAT is a relatively new tool developed and validated by the University of Minnesota’s Department of Pharmaceutical Care and Health Systems to assess the level of support for CMM within an organization [ 12 ]. Due to its recent development, the use of the PMAT is limited and few articles have been published on its application in a novel environment.…”