Pharmacy technician involvement in community pharmacy medication therapy management.

OBJECTIVES: To assess the impact of technician involvement on the completion of medication therapy management (MTM) services in a community pharmacy setting and to describe pharmacists' and technicians' perceptions of technician involvement in MTM-related tasks and their satisfaction with the technician's role in MTM. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: In the fall of 2015, pharmacists and selected technicians from 32 grocery store-based community pharmacies were trained to use technicians within MTM services. MAIN OUTCOME MEASURES: Completed MTM claims were evaluated at all pharmacies for 3 months before training and 3 months after training. An electronic survey, developed with the use of competencies taught in the training and relevant published literature, was distributed via e-mail to trained employees 3 months after training. RESULTS: The total number of completed MTM claims at the 32 pharmacy sites was higher during the posttraining time period (2687 claims) versus the pretraining period (1735 claims). Of the 182 trained participants, 112 (61.5%) completed the survey. Overall, perceived technician involvement was lower than expected. However, identifying MTM opportunities was the most commonly reported technician MTM task, with 62.5% of technicians and 47.2% of pharmacists reporting technician involvement. Nearly one-half of technicians (42.5%) and pharmacists (44.0%) agreed or strongly agreed they were satisfied with the technician's role in MTM services, and 40.0% of technicians agreed that they were more satisfied with their work in the pharmacy after involvement in MTM. CONCLUSION: Three months after initial training of technicians in MTM, participation of technicians was lower than expected. However, the technicians involved most often reported identifying MTM opportunities for pharmacists, which may be a focus for future technician trainings. In addition, technician involvement in MTM services may increase satisfaction with many aspects of work for actively involved technicians.

A structured patient identification model for medication therapy management services in a community pharmacy.

OBJECTIVES: To describe the development and implementation of a structured patient identification model for medication therapy management (MTM) services within traditional dispensing activities of a community pharmacy to facilitate pharmacist-provided completion of MTM services. DESIGN: A daily clinical opportunity report was developed as a structured model to identify MTM opportunities daily for all MTM-eligible patients expecting to pick up a prescription. Pharmacy staff was trained and the standardized model was implemented at study sites. SETTING AND PARTICIPANTS: One hundred nineteen grocery store-based community pharmacies throughout Ohio, West Virginia, and Michigan. OUTCOME MEASURES: A structured patient identification model in a community pharmacy consists of reviewing a clinical opportunity report, identifying interventions for MTM-eligible patients, and possibly collaborating with an interdisciplinary team. This model allows pharmacists to increase MTM cases performed by providing a structured process for identifying MTM-eligible patients and completing MTM services. RESULTS: The development and implementation of a structured patient identification model in the community pharmacy was completed and consists of pharmacists reviewing a clinical opportunity report to identify MTM opportunities and perform clinical interventions for patients. In a 3-month pre- and post-implementation comparison, there was a 49% increase in the number of MTM services provided by pharmacists (P < 0.001). CONCLUSION: A structured patient identification model in the community pharmacy was associated with an increase in the amount of MTM services provided by pharmacists. This method could be a useful tool at a variety of community pharmacies to solve challenges associated with MTM completion.

Use of community pharmacy-provided diabetes services to aid physicians in the National Committee for Quality Assurance recognition program.

BACKGROUND: Pay-for-performance (P4P) models are being adopted by many health care payers, including Medicare, for payment of physician services. To receive financial incentives in P4P programs, physicians are encouraged to attain recognition or credentialing from an agency, such as the National Committee for Quality Assurance (NCQA). OBJECTIVE: To explore the potential roles of a community pharmacy-provided diabetes services in collaboration with physicians and to assist them in becoming acknowledged by the NCQA Diabetes Physician Recognition Program. SUMMARY: KDI Health Solutions pharmacists have demonstrated success in the management of diabetes through the Asheville Project and the Diabetes Ten City Challenge. Continued pharmacists' efforts may focus on expanding current disease state management programs, community pharmacy diabetes education programs, and collaborative practices with physicians. Studies are currently being conducted to assess physician willingness to use pharmacists as part of the NCQA recognition process. CONCLUSION: Collaboration of physicians and pharmacists may improve diabetes standards of care and aid physicians in becoming NCQA-recognized providers. NCQA-recognized physicians can align themselves with current and future P4P programs.

Assessing Ohio grocery store patrons' perceptions of a comprehensive medication review.

OBJECTIVE: To assess grocery store patrons' perceptions of a comprehensive medication review (CMR) compared with traditional prescription medication counseling. DESIGN: Self-administered survey. SETTING: Eight central Ohio grocery stores during January through April 2007. PARTICIPANTS: Grocery store patrons. INTERVENTION: Survey events. MAIN OUTCOME MEASURES: Responses to survey items about CMRs and prescription medication counseling indicated (1) who study participants would expect to deliver each program, (2) where they would expect services to be offered, and (3) what they would expect to be included or discussed. RESULTS: Predefined response options were provided for each question. The majority of the 214 study participants associated physicians or pharmacists with a CMR. CMRs were thought to be provided in medical offices or pharmacies. Only 3 of 24 qualifiers were statistically significantly different when comparing CMRs and prescription medication counseling (inclusion of health and wellness screenings [55% vs. 43%, P = 0.015], discussion about any of the patients' medications being the same [45% vs. 56%, P = 0.026] and "other" [6% vs. 12%, P = 0.021]). CONCLUSION: Patients may not recognize pharmacists as primary providers of CMRs and may not see a clear distinction between a CMR and prescription medication counseling. More research is needed in this area to further solidify the results. Pharmacists need to market themselves as willing and capable individuals of providing CMRs. Additionally, pharmacists should highlight key differences between a CMR and prescription medication counseling so that patients understand the value of a CMR.

Impact of interprofessional activities on health professions students' knowledge of community pharmacists' role and services.

OBJECTIVES: To determine the impact of health professions students' participation in interprofessional activities on their knowledge of the roles of community pharmacists and community pharmacist-provided services. METHODS: Students at the Medical University of South Carolina were surveyed via a self-administered online survey tool to determine their participation in interprofessional activities as well as their knowledge of the role of community pharmacists and community pharmacist-provided services. RESULTS: Over 600 students completed the survey instrument. Nonpharmacy students who attended the university-sponsored Interprofessional Day were more knowledgeable of pharmacist-provided services. Previous interaction with a pharmacist increased nonpharmacy students' awareness of the services that pharmacists provide. CONCLUSION: Participation in interprofessional activities increased health professions students' awareness of the role of pharmacists. Continued education among healthcare professions about the role of and services provided by pharmacists is needed to ensure that pharmacists have the greatest possible impact on patient care.