University of Missouri-Kansas City School of Pharmacy, 807 Lewis Hall, 701 S. 5th St, Columbia, MO, 65211, USA; University of Missouri Health Care, 1 Hospital Dr, Columbia, MO, 65211, USA.
Res Social Adm Pharm. 2023 Jun;19(6):889-895. doi: 10.1016/j.sapharm.2023.02.006. Epub 2023 Feb 18.
Demonstrating the value of comprehensive medication management (CMM) within clinical faculty sites is a challenge when balancing patient volume with academic responsibilities. Utilizing an evidence-based implementation system for CMM, faculty primary care clinical pharmacists (PCCPs) standardized CMM within their practice sites.
The primary objective of this project was to define the value of faculty PCCPs.
An Ambulatory Care Summit was hosted to identify opportunities for consistency of CMM. Following the summit, the CMM implementation team (faculty PCCPs and project manager) utilized CMM implementation tools from the Comprehensive Medication Management in Primary Care Research Team. Additionally, a strategic plan was developed to enhance practice management, improve fidelity, and determine key performance indicators (KPIs). Five faculty-mentored student projects assessed value of faculty-delivered CMM in primary care clinics. Data included medication adherence metrics, clinic quality metrics, diabetes metrics, acute healthcare utilization rates, and a physician satisfaction survey.
Among those receiving CMM, adherence improved 14% (P = 0.022), 119 clinic quality metrics were achieved, HbA1c ≤ 9% improved 45% (p < 0.001), average HbA1c decreased by 1.73% (p < 0.001), and medication preventable acute care utilization within the referral reason decreased. Over 90% of physicians surveyed agreed the faculty PCCP is a valuable team member, improved patients' health, and improved effectiveness/efficiency. Four student posters were presented at national conferences and 18 student pharmacists were engaged in various aspects of the project.
Incorporating CMM at faculty primary care clinics provides value. To demonstrate this value, faculty must align KPIs with institution-specific payer contracts.
在平衡患者量与学术职责的情况下,展示临床教师站点综合药物管理(CMM)的价值具有挑战性。临床药师利用循证实施系统为 CMM 提供服务,将 CMM 标准化到他们的实践站点。
该项目的主要目标是确定临床药师的价值。
举办了一次门诊护理峰会,以确定 CMM 一致性的机会。峰会结束后,CMM 实施团队(临床药师和项目经理)利用综合药物管理在初级保健研究团队中的实施工具。此外,制定了一项战略计划,以加强实践管理,提高保真度,并确定关键绩效指标(KPI)。五项由教师指导的学生项目评估了在初级保健诊所提供教师交付的 CMM 的价值。数据包括药物依从性指标、诊所质量指标、糖尿病指标、急性医疗保健利用率和医生满意度调查。
在接受 CMM 的人群中,依从性提高了 14%(P = 0.022),实现了 119 个诊所质量指标,HbA1c≤9%提高了 45%(p<0.001),平均 HbA1c 降低了 1.73%(p<0.001),并降低了因药物导致的可预防的急性护理利用率。接受调查的医生中,超过 90%的医生同意临床药师是有价值的团队成员,改善了患者的健康状况,提高了有效性/效率。有 4 篇学生海报在全国会议上展示,18 名学生药师参与了该项目的各个方面。
在教师初级保健诊所实施 CMM 具有价值。为了证明这一价值,教师必须将 KPI 与机构特定的支付者合同保持一致。