Transforming the Medication Regimen Review Process Using Telemedicine to Prevent Adverse Events

Kane‐Gill, Sandra L.; Wong, Adrian; Culley, Colleen M.; Perera, Subashan; Reynolds, Maureen; Handler, Steven M.; Kellum, John A.; Aspinall, Monica B.; Pellett, Megan E.; Long, Keith; Nace, David A.; Boyce, Richard D.

doi:10.1111/jgs.16946

Cited by 17 publications

(50 citation statements)

References 32 publications

(54 reference statements)

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“…By utilizing CMM, pharmacists can optimize patient outcomes in a generalized and evidence‐based manner across different pharmacy practice settings 14,15 . The clinical services offered by pharmacists via telehealth improve patient outcomes and increase medication adherence 18‐20 . However, researchers have not explored or assessed the implementation and application of CMM practices in the context of telehealth services offered by pharmacists.…”

Section: Introductionmentioning

confidence: 99%

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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IntroductionTelehealth offers a promising opportunity for the delivery of clinical pharmacy services by increasing the accessibility of health care, extending the reach of clinical services, and allowing pharmacists to engage with patients who might otherwise be overlooked. The objectives of the project were to discover effective strategies for the delivery of clinical pharmacy services via telehealth and to identify core components of comprehensive medication management (CMM) that are deliverable via telehealth.MethodsA systematic literature review was performed by searching four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], PubMed, Scopus, and Web of Science) for relevant citations using keywords and subject headings relating to telemedicine, clinical pharmacy services, and health conditions. Studies were eligible for inclusion in the review if the interventions they describe involved telehealth technologies and pharmacist care. Blind screening of abstracts and full‐text review was completed by six researchers divided into teams of two. Any discrepancies were resolved by the corresponding author.ResultsFifty‐nine studies met the inclusion criteria, most (n = 53) of which were conducted in the U.S. Five studies (8.5%) reported pharmacist training as an implementation strategy. The telehealth technologies most regularly utilized were telephone‐based interventions (n = 45), videoconferences (n = 13), and web‐based (n = 4) interventions, with five studies using a combination of technologies. Most studies focused on hypertension (n = 22), diabetes (n = 20), or lipid‐related (n = 14) disease state management. Eighteen studies qualified as CMM (n = 18), with most involving all five essential CMM functions.ConclusionThis systematic review study highlights opportunities for pharmacists to deliver clinical pharmacy services using telehealth. The majority of clinical pharmacy services described in the accessed literature was provided via telephone and focused on targeted monitoring of disease states. While studies reporting the use of CMM interventions were limited, there is an opportunity to increase the application of CMM principles as healthcare systems transition to providing more telehealth services.

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Section: Introductionmentioning

confidence: 99%

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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“…In total, 65% (11/17) of the studies defined the professional user group using the decision support tool, whereas 35% (6/17) did not indicate who the intended users of the tools were [ 11 , 13 , 17 , 21 , 24 , 25 ]. Where stated (5/11, 45%), the most commonly specified professionals were either care home staff or nursing home staff [ 10 , 14 , 18 , 22 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

Decision Support Tools in Adult Long-term Care Facilities: Scoping Review

Lapp¹,

Egan²,

McCann³

et al. 2022

J Med Internet Res

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Background Digital innovations are yet to make real impacts in the care home sector despite the considerable potential of digital health approaches to help with continued staff shortages and to improve quality of care. To understand the current landscape of digital innovation in long-term care facilities such as nursing and care homes, it is important to find out which clinical decision support tools are currently used in long-term care facilities, what their purpose is, how they were developed, and what types of data they use. Objective The aim of this review was to analyze studies that evaluated clinical decision support tools in long-term care facilities based on the purpose and intended users of the tools, the evidence base used to develop the tools, how the tools are used and their effectiveness, and the types of data the tools use to contribute to the existing scientific evidence to inform a roadmap for digital innovation, specifically for clinical decision support tools, in long-term care facilities. Methods A review of the literature published between January 1, 2010, and July 21, 2021, was conducted, using key search terms in 3 scientific journal databases: PubMed, Cochrane Library, and the British Nursing Index. Only studies evaluating clinical decision support tools in long-term care facilities were included in the review. Results In total, 17 papers were included in the final review. The clinical decision support tools described in these papers were evaluated for medication management, pressure ulcer prevention, dementia management, falls prevention, hospitalization, malnutrition prevention, urinary tract infection, and COVID-19 infection. In general, the included studies show that decision support tools can show improvements in delivery of care and in health outcomes. Conclusions Although the studies demonstrate the potential of positive impact of clinical decision support tools, there is variability in results, in part because of the diversity of types of decision support tools, users, and contexts as well as limited validation of the tools in use and in part because of the lack of clarity in defining the whole intervention.

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“…Successful implementation would allow nursing homes to address domains in the National Quality Forum measurement framework for telemedicine such as access to care for the patient, family and care team and the effectiveness and experience of the telemedicine encounter [ 34 ]. Although not a focus of this study, evidence suggests that the use of telemedicine in nursing homes improves resident health, and reduces adverse drug events, hospitalizations and emergency room transfers [ 7 , 28 , 31 , 35 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19

et al. 2022

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Introduction Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19. Methods Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited. Semi-structured interviews and surveys were employed to identify participant perceptions about the value of telemedicine, implementation challenges encountered, and plans and barriers to sustaining its delivery after COVID-19. Directed content analysis and a deductive thematic approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model was used during analyses. Quantitative and qualitative data were integrated to identify participant views on the value of telemedicine and the tools and work system enhancements needed to make telemedicine easier and more effective. Results All participating NHs indicated a preference to continue telemedicine after COVID-19. Urgent assessments of resident change-in-condition and cognitively based sub-specialty consultations were identified as the encounter types most amenable to telemedicine. Reductions in resident off-site encounters and minimization of resident therapy interruptions were identified as major benefits of telemedicine. Twelve work system enhancements needed to better sustain telemedicine were identified, including improvements to: 1) equipment/IT infrastructure; 2) scheduling; 3) information exchange; and 4) telemedicine facilitators. Discussion NHs that adopted telemedicine during COVID-19 wish to continue its use. However, interventions that enhance the integration of telemedicine into NH and off-site clinic work systems require changes to existing regulations and reimbursement models to sustain its utilization after COVID-19.

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Transforming the Medication Regimen Review Process Using Telemedicine to Prevent Adverse Events

Cited by 17 publications

References 32 publications

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Decision Support Tools in Adult Long-term Care Facilities: Scoping Review

There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19

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