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

2019 ◽  
Vol 3 (2) ◽  
pp. 438-447 ◽  
Author(s):  
Deborah L. Pestka ◽  
Caitlin K. Frail ◽  
Lindsay A. Sorge ◽  
Kylee A. Funk ◽  
Mary T. Roth McClurg ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Practice Management ◽  
Primary Care Clinics

scholarly journals Early Implementation of Comprehensive Medication Management within an Academic Medical Center Primary Care Pharmacy Team

2020 ◽  
Vol 11 (2) ◽  
pp. 1 ◽  
Author(s):  
Kyle Turner ◽  
Jenni Buu ◽  
Mary Kuzel ◽  
Eve Van Wagoner ◽  
Golden Berrett
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medication Management ◽  
Implementation Fidelity ◽  
Care Process ◽  
Implementation Framework ◽  
Primary Care Clinics ◽  
Clinical Pharmacists ◽  
University Of Utah ◽  
The Impact

Introduction: University of Utah Health is an academic health care system that serves residents in Utah and beyond. Clinical pharmacists with the health care system’s pharmacy primary care services (PPCS) team provide medication education, population-based care, and medication management through collaborative practice agreements. With the expansion of clinical pharmacist and technician positions and services, the need to measure and assess the impact of pharmacy services and create a value proposition for internal and external stakeholders became an important goal, and the decision was made to better align practices across all PPCS sites. This paper highlights University of Utah Health’s approach to implement comprehensive medication management (CMM) across all primary care clinics with embedded clinical pharmacy staff and subsequent evaluation of implementation fidelity. Methods: Implementation of CMM was assisted by participation in the National A3 Collaborative and by using selected principles from the Active Implementation Framework. Stages of implementation included exploration, instillation, and initiating improvement cycles. An implementation team consisting of PPCS employees was created to help with standardization, developing implementation plans, and creating a dissemination strategy for all PPCS team members. The CMM care process was subsequently presented and implemented by clinical pharmacists in primary care clinics. Following implementation, fidelity measures were collected including identification and resolution of medication therapy problems (MTPs) and responses from a questionnaire distributed to the clinical pharmacists to self-report understanding and implementation of CMM key elements. The number and type of MTPs identified were tracked over 18 months. Results: Within the measurement window, clinical pharmacists identified 17,953 MTPs. Of the total number of MTPs identified, 21% were related to indication, 53% to efficacy, 15% to safety and 11% to adherence. The questionnaire was distributed to clinical pharmacists 9 months after CMM implementation, with a 71% response rate. Pharmacists reported “always” or “often” performing each step in the patient care process as follows: indication (93%), effectiveness (93%), safety (87%), and adherence (93%). Reported barriers to implementation of the CMM include lack of time to complete all aspects of the process efficiently, lack of a standardized format for documentation, and changing practice habits. Conclusion: Implementation of a CMM process within University of Utah Health’s PPCS services with the help of a national collaborative and implementation framework yielded identification of 17,953 MTPs over 18 months and foundational fidelity to core principles.   Article type: Clinical Experience

scholarly journals COVID-19 Adaptations in the Care of Patients with Opioid Use Disorder: a Survey of California Primary Care Clinics

2021 ◽  
Author(s):  
Lauren Caton ◽  
Hannah Cheng ◽  
Hélène Chokron Garneau ◽  
Tammy Fisher ◽  
Briana Harris-Mills ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Medication Management ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Primary Care Clinics ◽  
Urine Drug ◽  
Disorder Treatment ◽  
Primary Care Practices ◽  
The Impact

Abstract Background With the onset of the COVID-19 crisis, many federal agencies relaxed policies regulating opioid use disorder treatment. The impact of these changes has been minimally documented. The abrupt nature of these shifts provides a naturalistic opportunity to examine adaptations for opioid use disorder treatment in primary care. Objective To examine change in medical and behavioral health appointment frequency, visit type, and management of patients with opioid use disorder in response to COVID-19. Design A 14-item survey queried primary care practices that were enrolled in a medications for opioid use disorder statewide expansion project. Survey content focused on changes in service delivery because of COVID-19. The survey was open for 18 days. Participants We surveyed 338 clinicians from 57 primary care clinics located in California, including federally qualified health centers and look-alikes. A representative from all 57 clinics (100%) and 118 staff (34.8% of all staff clinicians) participated in the survey. Main Measures The survey consisted of seven dimensions of practice: medical visits, behavioral health visits, medication management, urine drug screenings, workflow, perceived patient demand, and staff experience. Key Results A total of 52 of 57 (91.2%) primary care clinics reported practice adaptations in response to COVID-19 regulatory changes. Many clinics indicated that both medical (40.4%) and behavioral health visits (53.8%) were now exclusively virtual. Two-thirds (65.4%) of clinics reported increased duration of buprenorphine prescriptions and reduced urine drug screenings (67.3%). The majority (56.1%) of clinics experienced an increase in patient demand for behavioral health services. Over half (56.2%) of clinics described having an easier or unchanged experience retaining patients in care. Conclusions Many adaptations in the primary care approach to patients with opioid use disorder may be temporary reactions to COVID-19. Further evaluation of the impact of these adaptations on patient outcomes is needed to determine whether changes should be maintained post-COVID-19.

scholarly journals Assessing the State of Comprehensive Medication Management in a Sample of Primary Care Clinics

2019 ◽  
Vol 10 (1) ◽  
pp. 5 ◽  
Author(s):  
Debbie Pestka ◽  
Lindsay Sorge ◽  
Jordan Mendkoff ◽  
Caitlin Frail ◽  
Kylee Funk ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Original Research ◽  
Inclusion Criteria ◽  
Primary Care Clinics ◽  
Medication Therapy ◽  
Site Characteristics ◽  
Article Type ◽  
Care Costs ◽  
Shed Light

OverviewComprehensive medication management (CMM) is an important tool to address medication-related morbidity and mortality and reduce health care costs. Medication therapy problems (MTPs) are a significant and costly barrier to improving patient outcomes1 and with more than half of all Americans taking at least one prescription drug,2 the need to manage and optimize patients’ medications is greater than ever. This report examines select practice and practitioner characteristics of the primary care clinics that participated in the research project, Enhancing Performance in Primary Care Medical Practice through Implementation of Comprehensive Medication Management. To be eligible to participate, sites had to have: established relationships with care team providers, a way of electronically identifying patients most in need of CMM, reporting processes in place for CMM data, read/write access in the electronic medical record, and an established CMM practice or a commitment to providing CMM. Because of these inclusion criteria, most participating clinics had CMM services in place for several years and were mature in their design and delivery of services. Site characteristics around the following areas were assessed: pharmacist and clinic demographics, delivery of pharmacy services, collaboration, billing and payment for CMM, and measuring CMM outcomes. The results of this report shed light on how CMM is being delivered in a sample of established CMM practices and therefore may provide benefit to those practitioners interested in building their own CMM practice.   Article Type: Original Research

Physician-patient communication in the primary care clinics

2019 ◽  
pp. 120-123 ◽  
Author(s):  
Arwa Aseeri ◽  
Abdulmajeed Alswat ◽  
nAbdulelah Alessa ◽  
Abdulrahman ALAql ◽  
Osama Alkhudhairi ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Communication ◽  
Primary Care Clinics ◽  
Physician Patient Communication ◽  
Physician Patient
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