11 - Pharmaceutical care, medication therapy management and patient-centered care Flashcards
What came AFTER
“Pharmaceutical Care”
ACPE - 2007
Patient-Centered Care
&
Medication Therapy Management
What came AFTER
“Patient Centered Care”
Standards 2016
Pharmacists Patient Care Process
still focuses on patient-centered care
but
incorporates Team-based / Collaberative care model
Define:
a partnership of the
pharmacist, the patient or their caregiver, and other health professionals
that promotes the safe and effective use of medications
and helps
patients achieve the targeted outcomes from medication therapy.
MTM
Medication Therapy Management
PURPOSE of
MTM SERVICES
To optimize THERAPEUTIC OUTCOMES
To enhance Patient understanding / adherence
to decrease the likelyhood of adverse events
to reduce overall healthcare spending
Define:
•Services provided by a pharmacist that improve treatment outcomes for individual patients
- A professional service to promote the safe and effective use of medications
- A way to provide better care for patients
–Promotes collaboration among the patient, the pharmacist, and the patient’s other health care providers
MTM SERVICES
Spectrum of
Pharmacist-Provided MTM-Services
Comprehensive Medication Therapy Review
CMR
Adherence Services
Targetted Medication Intervention Programs
Disease State Management
Health / Wellness Services
5 Core Elements for MTM
in Community Pharmacies
CMR = Medication Therapy Review
Personal Med Record
Medication-Related action Plan
Intervention +/- Referral
Documentation / Follow Up
2017 Medicare MTM
Eligibility Criteria
CMS establishes minimum thresholds for individuals eligible for MTM services
- *Multiple Chronic Conditions**
- *2-3 conditions** = chronic - Diabiabetes / HT / heart failure
- *Taking Multiple Part-D Drugs**
- *2-8 medications** - MOST @ 8
- *likely to incur annual costs for covd part D drugs**
- *exceeding $3919**
Required MTM Services
sponsors MUST OFFER a minimum level of MTM serves
Interventions for beneficiaries & prescribers
- *CMR**
- *Annual** comprehensive Medicare Review
- *TMR**
- *Quarterly Targeted** medication Review
MTM Providers
ALL HAVE PHARMACISTS
second most is pharmacy interns
but can also be other professions
MTM Evidence
AHRQ DEcIDE
Randomized trial that showed that
MTM was associated with REDUCED DRP’s
but it had no effect on ADEs or Health Care use
PQA Study
showed that it did NOT matter if Telephone / in person
does not matter how it was delivered
Define:
Established in 2014
encompasses a contemporary and comprehensive approach to patient-centered care that is delivered in collaboration with other members of the health care team
PATIENT CARE PROCESS
developed by examining
Pharm care + MTM practice/guadance/evidence
Pharmacist’s Patient Care Process
Collect / Assess / Plan / Implement / Follow-Up
VVV
Collaborate / Communicate / Document
VVV
Patient-Centered Care
Inpatient Medication Use
PROCESS
BCMA = Bar Code Admin
–> can lead to a REDUCTION in errors up to
Administering
(nurses have to scan barcode b4 admin)
Prescribing -> transcribing
-> dispensing -> administering
-> monitoring -> QA ACTIVITIES
Ambulatory Medication Use
PROCESS
Prescribe -> dispense
-> self-admin -> monitor
- *—> reporting**
- VOLUNTARY safety reporting to Company or FDA*
