Case Study Examines Implementing Medication Therapy Management in Physician Office Settings

Involving students in advanced pharmacy practice experience rotations resulted in a greater overall impact.

Operationalizing platform-based medication therapy management (MTM) services allowed an ambulatory care pharmacy team to identify patients most in need of pharmacist involvement and to use free appointment time for these patients, according to a case study presented at ASHP Midyear 2021. The investigators said that involving students in advanced pharmacy practice experience (APPE) rotations in this work resulted in both a greater overall impact as well as positive feedback for the program as a training opportunity for the students.

At the institution reviewed, there were approximately 16,000 patients in family medicine and internal medicine to every pharmacist. Additionally, certain pharmacists’ schedules are filled by referrals and other network initiatives, whereas others had more open schedules.

Although clinical factors such as uncontrolled hemoglobin A1c or uncontrolled blood pressure can be used to identify additional patients who would benefit from ambulatory care pharmacist involvement, the investigators said it was possible to optimize the identification of high-risk patients with complex medication regimens who would benefit from pharmacist appointments.

To identify Medicare patients who would potentially benefit from an appointment with an ambulatory care pharmacist, the investigators developed workflows in an existing platform-based MTM system. Internal training was then provided to standardize the process for a pharmacist-driven, platform-based MTM service in physician offices.

Further, the COVID-19 pandemic resulted in an expansion of telehealth MTM services. Student workflows were designed in order to assist with administrative and patient care activities while simultaneously diversifying the activities available for the students’ learning experience.

According to the investigators, between January and December 2020, 371 MTM services were completed by 22 pharmacists, including 213 complete medication reviews and 158 targeted intervention programs. The services provided resulted in 247 documented clinical interventions and counseling points on 224 individual patients.

Appointments were largely provided via telehealth. Top pharmacist interventions were reflective of those commonly made in the ambulatory care setting, including addressing drug safety concerns and chronic disease therapy optimization and monitoring. The investigators noted that more services could be provided by pharmacists with students on rotation compared to those without students available, and APPE students were directly involved in 113 of these services.

REFERENCE

Wilhoite J, Dorrell M. Implementation of medication therapy management platform for pharmacist prioritization in physician office settings. Presented at: ASHP Midyear 2021. Accessed December 2, 2021.