Clinical outcomes of medication therapy management services in primary health care

Mendonça, Simone de Araújo Medina; Melo, Angelita Cristine de; Pereira, Gabriela Cristina Coelho; Santos, Danielle; Grossi, Elisa Brandão; Sousa, Maria do Carmo Vilas Boas; Oliveira, Djenane Ramalho de; Soares, Adriana Cristina

doi:10.1590/s1984-82502016000300002

Cited by 29 publications

(43 citation statements)

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“…Therefore, the primary aim of this study is to describe the newly implemented practice management system of CMM services at the county health centre in Croatia. In addition, various studies have demonstrated its effectiveness on clinical (14,15,(17)(18)(19)(20)(21)(22)(23)(24), economic (17,22,23,25) and humanistic outcomes (26,27). Other studies determined some factors associated with the occurrence of DTPs, such as polypharmacy, multimorbidity and age, yet employed methodology or clinical settings dissimilar to the present study (28)(29)(30)(31).…”

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confidence: 93%

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Implementation of medication management services at the primary healthcare level – a pilot study

et al. 2019

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This study employed a mixed-method approach to enable the implementation of comprehensive medication management (CMM) services in Croatia’s primary care setting. Drug therapy problems (DTPs) and factors associated with their occurrence were determined in patients with chronic diseases from January 2018 to April 2019. The pre-implementation stage established the foundations for the early implementation stage, in which the practice was set up, the patients’ recruitment initiated and various challenges identified. During the study period, 86 patients were recruited for CMM provision. Overall, 2.8 DTPs (± 1.6) per patient were identified and the majority (96.2 %) presented with at least one DTP. Multiple regression analysis showed that type 2 diabetic patients (p = 0.025) and patients using five or more medications (p = 0.011) should be prioritized to receive CMM services as potentially they have a higher number of DTPs, and could, therefore, obtain a greater benefit from the service.

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confidence: 93%

“…Apart from the USA, several countries (e.g. Great Britain, Australia, Canada and Brazil) have managed to integrate CMM services into their existing health care system at the primary care level (11)(12)(13)(14)(15)(16).…”

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confidence: 99%

Implementation of medication management services at the primary healthcare level – a pilot study

et al. 2019

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“…The benefits of CMM services are numerous and include improved clinical outcomes 11,12,15,[28][29][30][31][32] , decreased medical costs 17,[32][33][34] , better access to health care services, time-savings to other health care providers, reduced adverse drug events, as well as significant impact on the appropriateness, effectiveness, safety and compliance with medications 18 . The ability of CMM to improve patient outcomes and provide system-wide benefits has been well documented 35 .…”

Section: The Value Of Medication Management Servicesmentioning

confidence: 99%

“…However, this is no longer true. CMM services are supported by a vast evidence-based literature 6,[10][11][12][13]15 and grounded in the practice of pharmaceutical care, as proposed by Cipolle, Strand and Morley 14,16,17 . It is also promoted by several organizations such as the American College of Clinical Pharmacy 18,19 , Get the Medications Right Institute 20 , and Patient-Centered Primary Care Collaborative, which includes more than 500 organisations, all active stakeholders in the health-care system 2 .…”

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Comprehensive Medication Management Services as a Solution to Medication Mismanagement: A European Perspective

Mucalo¹,

Brajković²,

Jukić³

et al. 2019

Rad Hrvatske akademije znanosti i umjetnosti

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Due to an increase in the prevalence of chronic diseases, medication use and their cost is rising rapidly. This scenario render chronic patients at an increased risk of experiencing drug therapy problems, subsequently leading to unfavourable clinical and economic outcomes. Thus, to ensure patients' optimal medication use and improve their clinical outcomes, a comprehensive and systematic management of medications is deemed crucial. Hence, Comprehensive Medication Management (CMM) services offered by trained pharmacists can fill this gap by decreasing the unnecessary and often harmful use of medicines and consequent resulting complications. Collaborative practice between pharmacists and general practitioners, together with patients' active participation in the definition of treatment regimens, plays an important role in the effectiveness of CMM services. CMM services is defined as the standard of care that ensures each patient's medications (prescription, non-prescription, 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 taken, and that the patient is able to take them as intended. It includes an individualized care plan that achieves the intended goals of therapy with appropriate follow-up to determine actual patient outcomes. Apart from the USA, several countries (e.g. Australia, Canada and Brazil) have managed to integrate CMM services into their existing health care system at the primary care level. However, in Europe, in spite of the widespread recognition of the need for medication management services, initiation and implementation of CMM services are lagging behind. Hence, for CMM services to become a reality in Europe and elsewhere, numerous prerequisites need to be accomplished, including policies and legal regulations supporting the provision of CMM services on a much larger scale, clearly defined and standardized professional practice and common language shared among the pharmacists, and well trained and experienced practitioners providing full-time, direct patient care. Sažetak: Sveobuhvatna uSluga upravljanja farmakoterapijom kao rješenje za propuSte u propiSivanju lijekova: europSka perSpektivaZbog porasta prevalencije kroničnih bolesti, potrošnja lijekova ubrzano raste. Uslijed toga, kronični bolesnici su izloženi povećanom riziku pojave terapijskih problema što dovodi do nepovoljnih kliničkih i ekonomskih ishoda liječenja. Stoga se smatra da je sveobuhvatno i sustavno upravljanje farmakoterapijom ključno za osiguranje optimalne uporabe lijekova kao i za poboljšanje kliničkih ishoda liječenja. Sveobuhvatna usluga upravljanja farmakoterapijom (engl. Comprehensive Medication Management Services, CMM services) koju provode posebno educirani ljekarnici može ponuditi rješenje za ovaj problem, smanjujući nepotrebnu, a često i štetnu primjenu lijekova te njene posljedične komplikacije. Kolaborativna praksa ljekarn...

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“…Diversos trabalhos evidenciam os impactos positivos dessa prática, tanto para o paciente quanto para os profissionais envolvidos no cuidado, e ainda os benefícios associados à inserção desse serviço clínico nas equipes multidisciplinares (Isetts et al, 2008;Oliveira, Brummel e Miller, 2010;Mourão et al, 2013;Hirsch et al, 2014;Obreli-Neto et al, 2015;Mendonça et al, 2016;Detoni et al, 2017;Oliveira et al, 2017).…”

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A Prática Clínica Do Farmacêutico No Núcleo De Apoio À Saúde a Família

et al. 2018

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Resumo Este estudo teve como objetivo compreender os elementos essenciais do processo de sistematização da prática clínica de uma farmacêutica da atenção primária à saúde com base no referencial teórico-metodológico da atenção farmacêutica, que subsidia o serviço clínico de gerenciamento da terapia medicamentosa. Tratouse de pesquisa qualitativa autoetnográfica, construída de forma colaborativa entre os autores, de outubro de 2014 a outubro de 2015, nos Centros de Saúde da Prefeitura Municipal de Belo Horizonte, onde uma das autoras trabalha. Os dados foram produzidos por meio de observação participante, diários de campo, reflexões e entrevistas semiestruturadas com farmacêuticos que desenvolviam prática clínica na atenção primária à saúde. Os resultados evidenciaram que os principais elementos para sistematização da prática clínica passam pela 'construção de uma nova identidade profissional na equipe multiprofissional' e pela 'incorporação de novas atividades na rotina de trabalho' que, combinadas, resultam em uma 'proposta de integração de um serviço de gerenciamento da terapia medicamentosa nos fluxos das unidades de saúde'. Dessa forma, para que o farmacêutico possa legitimar o seu papel no cuidado do paciente, é preciso mudar, transformar, reorganizar e reconstruir a sua prática. Palavras-chave autoetnografia; atenção primária à saúde; gerenciamento da terapia medicamentosa; atenção farmacêutica.Abstract The aim of this study was to understand the essential elements of the systematization process of the clinical practice of a pharmacist in primary health care. This systematization was based on the framework of pharmaceutical care practice, which provides the foundation for comprehensive medication management services. The methodology utilized was autoetnography, built collaboratively between the authors. The data have been produced through participant observation, field journals, reflections and semi structured interviews with pharmacists who are building clinical practices in primary health care. The results have demonstrated that the main elements associated with the systematization of clinical practices are 'the construction of a new professional identity in a multiprofessional team' as well as 'the incorporation of new activities in the work routine', that, combined, result in 'Integration of comprehensive medication management services in the flow of the health unit'. In this way, in order for the pharmacist to legitimize his role in patient care, it is necessary to change, to transform, to reorganize and to rebuild his practice.

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Clinical outcomes of medication therapy management services in primary health care

Cited by 29 publications

References 29 publications

Implementation of medication management services at the primary healthcare level – a pilot study

Implementation of medication management services at the primary healthcare level – a pilot study

Comprehensive Medication Management Services as a Solution to Medication Mismanagement: A European Perspective

A Prática Clínica Do Farmacêutico No Núcleo De Apoio À Saúde a Família

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