Development and implementation of a pharmacist-run comprehensive medication review program in Wisconsin

Schoenrock, Danielle L.; Hartkopf, Katherine; Boeckelman, Carrie

doi:10.2146/ajhp160185

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Comprehensive medication review (CMR) is a service offered to patients in order to optimize their medication regimens to help prevent potential adverse drug reactions and improve their overall disease management [5]. Several studies have been published looking at the perception of CMR for both patients and providers alike which indicate an overall positive reaction to the services when available [5][6][7]. While CMR services are well received, there have only been a handful of studies looking at the effectiveness of the programs on elderly patient outcomes [8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

J Geriatr Med Gerontol

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Background: The purpose of this project was to conduct pharmacotherapeutic management of patients in the outpatient setting in a standardized manner. A CMR program was implemented at select ambulatory care sites within our healthcare system. This review identified and addressed medication-related concerns in order to optimize disease state management and attain positive patient outcomes. Methods: This prospective review included patients 80 years or older with polypharmacy concerns, categorized as having greater than 10 medications. Evaluation assessed for therapeutic duplications, potential interactions, side effects, inappropriate medications in the elderly, pharmacoeconomic issues and adherence concerns. All data was collected through the outpatient electronic health record. The primary outcome was the number and type of interventions identified through CMR. Secondary outcomes included percent of recommendations accepted, reasons for rejection, types of recommendations, and disease states intervened on. Results: Out of a total of 222 patients, 52 patients did not require any interventions and 250 recommendations were made to the providers on the 170 remaining patients. Currently 82% of recommendations were accepted by providers, with 17% still pending provider acknowledgement, and 1% being rejected. A large majority, 141 recommendations, were made in regards to high risk medications. Conclusion: CMR was shown to be highly effective in identifying appropriate medication interventions in order to optimize patient care. This study provided the framework to move pharmacists into other outpatient sites in the healthcare setting to assist in targeting inappropriate prescribing in the elderly.

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Section: Discussionmentioning

confidence: 99%

Untitled

2019

J Geriatr Med Gerontol

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Medication review service implementation in community pharmacy settings: Scoping review with focus on implementation studies

Brandt

Lê

Jantscher

et al. 2020

Research in Social and Administrative Pharmacy

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Background: Medication reviews are a structured clinical intervention with the general goals of improving patient drug knowledge and detecting and resolving drug-related problems in an individual patient's medication regimen. A variety of barriers entrenched in the traditional drug distribution and dispensing model of pharmacy business has continued to challenge the implementation efforts of medication review services worldwide in the community pharmacy setting.Main Objectives: i) Characterize original research studies that sought to enhance medication review service implementation in community pharmacy settings. ii) Categorize the broader corpus of scientific literature (beyond original implementation studies) on medication review service implementation in community pharmacy settings.Methods: a broad systematic search strategy was applied to ovid MEDLINE, Embase, CINAHL and Cochrane Library to create an over-arching view and extensively ordered bibliography of the diverse research publication types dealing with the topic of medication review service implementation in the community pharmacy setting. A scoping review was subsequently conducted on original research studies that utilized various strategies to enhance the implementation of this service in community pharmacies. Data-charting evaluated the location of implementation studies, the strategies undertaken, the scale of implementation strategies, the use of DII (Dissemination, Implementation and Improvement) science theory, sample sizes, and DII outcomes.Results: Of 5,947 records screened, 419 fulfilled the inclusion criteria (from abstract screening) to be deemed suitable for categorization and inclusion into the broader survey on this topic. Of these 419 publications, only 75 were original research specifically focused on enhancing the implementation of medication reviews in community pharmacy. A large majority of the publications were qualitative studies (n = 203). The remaining articles were improvement studies (n = 36), descriptive observational studies (n = 49), reviews (n = 69) and methodology papers (n = 16). Twenty-nine of these articles were deemed suitable for inclusion in more than one category. After full-text screening, 41 of the 75 implementation publications, representing 40 original studies, published between 1999-2019, were eligible for data-charting. The majority of these studies occurred in North America (n = 30), used some form of education as the most common implementation strategy (n = 22) and measured 'adoption' (extent or frequency of medication reviews delivered) most frequently as an implementation outcome (n = 30). Just over half of the studies used a multi-faceted implementation strategy (n = 21). Only 9 studies used a theory, model or framework at any point in the research process to test hypotheses or explain empirical findings. Conclusions:There is an abundance of publications addressing various issues surrounding medication review implementation in community pharmacies. However, the literature appears disproportionately repre...

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Development and implementation of a pharmacist-run comprehensive medication review program in Wisconsin

Cited by 2 publications

References 7 publications

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Medication review service implementation in community pharmacy settings: Scoping review with focus on implementation studies

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