Preparing for implementation of a medication reconciliation measure for dialysis: Expanding the role of pharmacy technicians

Codd, Christopher; Martinusen, Daniel J; Cardone, Katie E.; Cho, Katherine; Pai, Amy Barton

doi:10.1093/ajhp/zxaa077

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…In the existing literature pharmacy technicians may play an important role in TOC programs, with TOC programs employing pharmacy technicians in traditional and novel roles to expand TOC programs [ 25 – 27 ]. Most consistently, pharmacy technicians have been used to collect medication histories and reconciliation, with technicians completing these activities successfully in a number of interventions [ 28 – 30 ]. While the PHARM-DC intervention does not explicitly require or recommend pharmacy technicians or additional support personnel to complete intervention components, the inclusion and training of such individuals may provide a cost-effective alternative to some pharmacist-delivered intervention components within the PHARM-DC intervention [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

A qualitative dual-site analysis of the pharmacist discharge care (PHARM-DC) intervention using the CFIR framework

Murry

Keller

Pevnick

et al. 2022

BMC Health Serv Res

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Introduction Older adults face several challenges when transitioning from acute hospitals to community-based care. The PHARMacist Discharge Care (PHARM-DC) intervention is a pharmacist-led Transitions of Care (TOC) program intended to reduce 30-day hospital readmissions and emergency department visits at two large hospitals. This study used the Consolidated Framework for Implementation Research (CFIR) framework to evaluate pharmacist perceptions of the PHARM-DC intervention. Methods Intervention pharmacists and pharmacy administrators were purposively recruited by study team members located within each participating institution. Study team members located within each institution coordinated with two study authors unaffiliated with the institutions implementing the intervention to conduct interviews and focus groups remotely via telecommunication software. Interviews were recorded and transcribed, with transcriptions imported into NVivo for qualitative analysis. Qualitative analysis was performed using an iterative process to identify “a priori” constructs based on CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation) and to create overarching themes as identified during coding. Results In total, ten semi-structured interviews and one focus group were completed across both hospitals. At Site A, six interviews were conducted with intervention pharmacists and pharmacists in administrative roles. Also at Site A, one focus group comprised of five intervention pharmacists was conducted. At Site B, interviews were conducted with four intervention pharmacists and pharmacists in administrative roles. Three overarching themes were identified: PHARM-DC and Institutional Context, Importance of PHARM-DC Adaptability, and Recommendations for PHARM-DC Improvement and Sustainability. Increasing pharmacist support for technical tasks and navigating pharmacist-patient language barriers were important to intervention implementation and delivery. Identifying cost-savings and quantifying outcomes as a result of the intervention were particularly important when considering how to sustain and expand the PHARM-DC intervention. Conclusion The PHARM-DC intervention can successfully be implemented at two institutions with considerable variations in TOC initiatives, resources, and staffing. Future implementation of PHARM-DC interventions should consider the themes identified, including an examination of institution-specific contextual factors such as the roles that pharmacy technicians may play in TOC interventions, the importance of intervention adaptability to account for patient needs and institutional resources, and pharmacist recommendations for intervention improvement and sustainability. Trial registration NCT04071951.

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Section: Discussionmentioning

confidence: 99%

A qualitative dual-site analysis of the pharmacist discharge care (PHARM-DC) intervention using the CFIR framework

Murry

Keller

Pevnick

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Studies have found that pharmacy technicians may be a costeffective and efficient staffing solution. 11,31 Tools such as artificial intelligence decision support software and hardware (eg, tablets) in primary care clinics may assist with medication reconciliation, increase patient engagement, and assist in creating the best possible medication history. 32,33 Dialysis organizations should create appropriate policy and procedures, training materials for professionals conducting medication reconciliation, and track medication reconciliation metrics in a clinic Quality Assurance and Performance Improvement program.…”

Section: Medication Reconciliation In Dialysis Unitsmentioning

confidence: 99%

Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis

Frament¹,

Hall

Manley³

2020

American Journal of Kidney Diseases

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“…Re‐allocation of technician duties can expand pharmacists' clinical roles and create opportunities for implementation of new services 59 . Importantly, certified pharmacy technicians are considered qualified personnel in the upcoming medication reconciliation Quality Incentive Program in dialysis facilities 60 . Technicians and clinical pharmacists should identify innovative models to maximize efficiency and maintain quality.…”

Section: Tools For Implementation Of Pharmacist‐based Care In Kidney mentioning

confidence: 99%

Nephrology practice and research network opinion paper: Pharmacists' perspectives on the Advancing American Kidney Health initiative

Meaney

Manley²,

Pai

et al. 2020

J Am Coll Clin Pharm

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Patients with chronic kidney disease (CKD) are at high risk for clinically significant medication therapy problems (MTPs) due primarily to the complex pharmacotherapy prescribed by numerous providers, and the significant changes in pharmacokinetic and pharmacodynamic properties of many medications due to their kidney disease. While MTPs are well recognized, pharmacists are not routinely involved in the health care teams that provide care for patients with CKD. The Advancing American Kidney Health initiative was announced in July 2019 and is poised to shift models of care in nephrology toward value‐based payment. This represents an opportunity for pharmacists to integrate into teams to improve quality of care and outcomes for patients with CKD. Pharmacists should engage in medication reconciliation, transitions of care, and medication‐focused kidney disease education programs within a comprehensive medication management (CMM) framework to optimize pharmacotherapy outcomes. To implement these services, pharmacists need to utilize certified pharmacy technicians, telehealth, interprofessional skills, and other tools in innovative ways. Current models of successful practice from Canada can serve as a template for United States‐based nephrology pharmacy practice. In this opinion paper, we characterize the current state of nephrology practice and identify significant opportunities for advancement. We propose metrics to evaluate pharmacy services and a framework for key stakeholder engagement which will be critical to advance the profession of pharmacy within nephrology. The Advancing American Kidney Health initiative offers a distinct opportunity to demonstrate the value of CMM provided by pharmacists in the nephrology arena to optimize patient care.

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Preparing for implementation of a medication reconciliation measure for dialysis: Expanding the role of pharmacy technicians

Cited by 8 publications

References 12 publications

A qualitative dual-site analysis of the pharmacist discharge care (PHARM-DC) intervention using the CFIR framework

A qualitative dual-site analysis of the pharmacist discharge care (PHARM-DC) intervention using the CFIR framework

Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis

Nephrology practice and research network opinion paper: Pharmacists' perspectives on the Advancing American Kidney Health initiative

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