Measuring implementation of medication optimization services: Development and validation of an implementation outcomes questionnaire

Livet, Melanie; Blanchard, Carrie; Richard, Chloe; Sheppard, Kelly; Yannayon, Mary; Sorensen, Todd D.; McClurg, Mary Roth

doi:10.1016/j.sapharm.2021.01.001

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…Surveys included demographic questions, the Implementation Outcomes Questionnaire (IOQ) scales to measure acceptability, appropriateness, and feasibility, 18 a service satisfaction survey, 19 and an adapted version of the Behavioral Intent to Use measure to assess intent to sustain use of the service 20 . These surveys were collected toward the end of the study from the lead pharmacists, pharmacy managers, and clinic team members who were involved in the implementation phase.…”

Section: Methodsmentioning

confidence: 99%

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Integrating comprehensive medication management in specialty clinics: A feasibility study

Livet

Richard

Pathak

et al. 2023

J Am Coll Clin Pharm

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Introduction: Patients dealing with complex medical conditions requiring specialty care and polypharmacy therapy experience many challenges, including the lack of adequate medication optimization services. Pharmacists within specialty clinics are uniquely positioned to improve patient care by offering comprehensive medication management (CMM) services.Objectives: This study explores the feasibility of CMM delivery by clinical pharmacists within specialty clinics. More specifically, it aimed to (1) assess the pharmacists, pharmacy managers, and clinic team members' experience with CMM implementation; and (2) evaluate preliminary evidence of treatment effectiveness.Methods: Seven specialty clinics within an academic medical center were recruited to prepare for, implement, and evaluate CMM over an 18-month period, with two additional clinics joining mid-project. This exploratory feasibility study used mixed data to understand levels of service adoption, evaluate changes in feasibility indicators (acceptability, appropriateness, practicality, intent to continue use, and satisfaction), collect implementation feasibility insights, and evaluate treatment outcomes, both perceived and based on medication therapy problem (MTP) resolution rates. Data sources included administrative data, surveys, interviews, and MTP documentation.Results: Service uptake was highly context dependent, with three of the five clinics discontinuing participation doing so because of challenges with service fit (appropriateness). For the four clinics implementing CMM throughout the study, the benefits were evidenced by the positive changes in the feasibility indicators ratings, perceived improved patient care, and a 96.2% MTP resolution rate. Gaining an understanding of CMM as a service and its potential role within a specialty clinic, ensuring buy-in from clinics and management, identifying implementation strategies such as preparation of workflows, and using a standardized MTP documentation form were highlighted as critical to successful implementation. Conclusion:Providing CMM as a service option for complex patients in specialty care clinics was deemed feasible and beneficial, providing alignment with the clinic culture, patient care approach, and pharmacist role.

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Section: Methodsmentioning

confidence: 99%

“…The information sources for this study included administrative data, surveys, interviews, and MTP data. Table 1 [18][19][20] provides a detailed overview of the data collection methodology and timeline. In summary, clinic enrollment study records (e.g., clinic enrollment logs) were used to assess service adoption.…”

Section: Data Collection and Analysismentioning

confidence: 99%

Integrating comprehensive medication management in specialty clinics: A feasibility study

Livet

Richard

Pathak

et al. 2023

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mixed methods data reported in this manuscript span the first 3 months of service implementation, and are part of a broader effectiveness‐implementation hybrid type 2 study 20 . Table 1 21,22 describes and aligns the aims of the study, the data types and sources, data indicators, and data collection details. In summary, to identify successes, challenges, and lessons learned thus far (Aim 1), qualitative data were gathered through interviews with clinic champions (N = 6), open‐ended survey questions with clinic staff and providers (N = 18), and pharmacists' logs.…”

Section: Methodsmentioning

confidence: 99%

“…The Clinic Survey , collected from the clinic champions, providers, and staff (N = 22), quantitatively assessed service acceptability, appropriateness, feasibility, and intent to maintain use as indicators of implementation success. The Survey details (ie, number of items, response scale, cited references for psychometric properties) can be found in Table 1 21,22 . Finally, MTPs , collected through an online MTP documentation tool used by the pharmacists as part of service delivery, were used as a proxy to assess the preliminary effectiveness of the CMM telepharmacy service 23,24 .…”

Section: Methodsmentioning

confidence: 99%

Feasibility of a CMM telepharmacy service for patients with diabetes in rural and underserved communities: Preliminary results

Livet

Levitt

Cardenas

et al. 2021

J Am Coll Clin Pharm

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IntroductionPatients with uncontrolled diabetes living in rural and underserved communities experience many challenges, including lack of access to needed health and medication management services. Telepharmacy has been identified as a promising approach for addressing this gap. This article describes early insights into the implementation and effectiveness of a comprehensive medication management (CMM) telepharmacy service offered as part of primary care clinics in North Carolina and Arkansas. The CMM service involved pharmacists meeting remotely with patients in their homes to identify and resolve medication‐related problems (MTPs).ObjectivesThe purpose of this article is to both describe early successes, challenges, and lessons learned, and summarize preliminary effectiveness results.MethodsThis exploratory study made use of mixed methods data spanning the first three months of implementation. Successes, challenges, and lessons learned were captured through clinic interviews, open‐ended survey questions, and pharmacists' logs. Evidence of implementation progress and success was based on administrative data and implementation outcomes survey results. Medication therapy problems (MTPs) were used as a proxy to assess preliminary service effectiveness.ResultsKey insights centered on the perceived benefits of the service for patients and clinics, the importance of patient outreach and engagement, access to implementation support strategies, and the need for adaptability. Implementation success was rated highly by clinic stakeholders, with significant increases in service acceptability, appropriateness, and feasibility over time, and continued intent to maintain the service. The MTP resolution rate averaged 88% across pharmacists.ConclusionThese preliminary data are promising for supporting the value of a pharmacist‐led medication optimization service delivered remotely to complex patients with uncontrolled diabetes. Ultimately, this model has the potential to expand access to care and transform the delivery of pharmacy services, while creating an opportunity to evolve the role of the clinical pharmacist beyond the traditional boundaries.

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“…Contudo, ainda falta padronização na definição e utilização desses indicadores de forma a possibilitar a comparação entre os processos de implementação, bem como verificar a qualidade do serviço prestado 27,28 .…”

Section: Planejamento Do Serviçounclassified

Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

et al. 2023

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O estudo teve como objetivo identificar e descrever a literatura científica sobre a implementação de serviços clínicos farmacêuticos que embasem a oferta de serviços de gerenciamento da terapia medicamentosa (GTM) nos sistemas de saúde. Realizou-se uma revisão narrativa de literatura com busca de artigos em revistas científicas especializadas na área. Após a seleção dos artigos, realizou-se a extração manual de informações relativas à implementação de serviços de GTM. Os dados foram agrupados segundo as fases de implementação de serviços clínicos: pré-implementação, implementação e pós-implementação. Para cada fase, foram identificados fatores que influenciam o processo de implementação de serviços clínicos. Espera-se que a partir deste trabalho novas pesquisas possam ser realizadas sobre a implementação do serviço de GTM, área ainda pouco explorada.

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Measuring implementation of medication optimization services: Development and validation of an implementation outcomes questionnaire

Cited by 10 publications

References 22 publications

Integrating comprehensive medication management in specialty clinics: A feasibility study

Integrating comprehensive medication management in specialty clinics: A feasibility study

Feasibility of a CMM telepharmacy service for patients with diabetes in rural and underserved communities: Preliminary results

Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

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