Abstract
Abstract
Objectives
(1) To develop an adaptation framework for MTM delivery for pharmacists (the MTM Adaptability Framework), (2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on MTM completion rates over a 2-year period, and (3) to explore pharmacists’ perceptions regarding knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention.
Methods
This study is a prospective, mixed-methods research study including a quasi-experimental, one-group pretest-posttest quantitative study with a sequential explanatory qualitative study arm featuring semi-structured key informant interviews. US supermarket pharmacy chain setting included 93 community pharmacy sites located in Tennessee, Kentucky, and Alabama. MTM completion rates are reported as percentage of completed comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs) and pharmacist perceptions.
Results
An 11.4% absolute increase in MTM completion rates was seen after the educational intervention targeting adaptation of MTM in the community pharmacy setting. This was found to be significant (46.92% vs. 58.3%; p < 0.001). Responses to the semi-structured interviews were mapped against CFIR and included themes: “knowledge and beliefs about MTM (pre-intervention),” “self-efficacy for MTM implementation (pre-intervention),” “knowledge and beliefs about MTM (post-intervention),” and “self-efficacy for MTM implementation (post-intervention).” Data convergence was found across these methodologies and suggested that targeting adaptability of MTM delivery increases MTM completion rates (quantitative data) and positively changes perceptions of MTM feasibility and self-efficacy (interviews).
Conclusion
The use of an educational intervention about adaptation of MTM to influence adaptation of MTM to a chain community pharmacy setting part of an implementation strategy improved MTM completion rates significantly. Future research should investigate combined implementation strategies and their impact on MTM implementation success.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Informatics,Health Policy,General Medicine
Reference56 articles.
1. Medication Therapy Management. Centers for Medicare & Medicaid Services. 2019. https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovcontra/mtm.html. Accessed 11 Feb 2019.
2. Community Pharmacists and Medication Therapy Management. Centers for Disease Control and Prevention. 2019. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/pharmacist-mtm.htm. Accessed 11 Feb 2019.
3. Theising KM, Fritschle TL, Scholfield AM, et al. Implementation and clinical outcomes of an employer-sponsored, pharmacist-provided medication therapy management program. Pharmacotherapy. 2015;35(11):e159–63.
4. Tsuyuki RT, Johnson JA, Teo KK, et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162(10):1149–55.
5. Carter BL, Barnette DJ, Chrischilles E, et al. Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting. Pharmacotherapy. 1997;17(6):1274–85.
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