Beneficiary, Caregiver, and Case Manager Perspectives on the Medication Therapy Management Program Standardized Format.

Plan sponsors of Medicare Part D must provide beneficiaries who receive a comprehensive medication review (CMR) with a written summary using the Medicare Part D Medication Therapy Management Standardized Format (SF). The SF is a means to advance consistency in the CMR program by providing a template of expected content. However, barriers remain with beneficiary use and integration into existing electronic health records. The current study assessed Medicare beneficiary, caregiver, and case manager perceptions of the SF through five focus group interviews with a total of 23 participants. Qualitative analysis found that beneficiaries and case managers preferred a consolidated SF document to share and update their entire health care team. Beneficiaries suggested adding information to the SF on dosage, timing, drug interactions, cost, and less expensive alternatives. Identifying elements of the SF that are perceived as useful to beneficiaries will allow for a more streamlined SF that may enhance interoperability among the health care team. [Journal of Gerontological Nursing, 45(4), 7-13.].

Implementation of a pharmacogenomics service in a community pharmacy.

OBJECTIVE To determine the feasibility of implementing a pharmacogenomics service in a community pharmacy. SETTING A single community pharmacy that is part of a regional chain known for offering innovative pharmacy services. PRACTICE DESCRIPTION Community pharmacists at the project site routinely provide clinical pharmacy services, including medication therapy management, immunizations, point-of-care testing, blood pressure monitoring, and diabetes education. PRACTICE INNOVATION The implementation of a pharmacogenomic testing and interpretation service for the liver isoenzyme cytochrome P450 2C19. PARTICIPANTS 18 patients taking clopidogrel, a drug metabolized by CYP2C19. MAIN OUTCOME MEASURES Rate of patient participation, rate of prescriber acceptance of pharmacist recommendation, time to perform genetic testing service, and number of claims submitted to and paid by insurance. RESULTS Of 41 patients taking clopidogrel and meeting project criteria, 18 (43.9%) enrolled and completed testing and interpretation of pharmacogenomic results. The mean time pharmacists spent completing all stages of the project with each participant was 76.6 minutes. The mean time to complete participation in the project (time between person's first and second visit) was 30.1 days. Nine patients had wild-type alleles, and pharmacists recommended continuation of therapy as ordered. Genetic variants were found in the other nine patients, and all pharmacist recommendations for modifications in therapy were ultimately accepted by prescribers. Overall, 17 patients consented to filing of reimbursement claims with their insurers. Five were not able to be billed due to submission difficulties. Of the remaining 12, none was paid. CONCLUSION A pharmacogenomics service can be an extension of medication therapy management services in a community pharmacy. Prescribers are receptive to having community pharmacists conduct pharmacogenomics testing, but reimbursement is a challenge.

Making pharmacogenetic testing a reality in a community pharmacy.

OBJECTIVE: To provide information for community pharmacies considering implementation of a pharmacogenetic testing service. SETTING: A single community pharmacy from a regional chain. PRACTICE DESCRIPTION: Community pharmacists at the study site routinely provide pharmacy services including medication therapy management, immunizations, point-of-care testing, blood pressure monitoring, and diabetes education. The pharmacy is a training site for post-graduate year 1 and 2 community-pharmacy residents and for introductory and advanced pharmacy practice experience students. PRACTICE INNOVATION: Implementation of a pharmacogenetics testing service in a community pharmacy. MAIN OUTCOME MEASURES: Feasibility of offering a pharmacogenetics testing service in a community pharmacy. RESULTS: Study investigators identified several internal and external barriers to the community pharmacy when initiating a pharmacogenetics service. This article shares experiences of the study team and solutions to the identified barriers. CONCLUSION: Community pharmacies interested in providing pharmacogenetic testing can overcome barriers by identifying practice partners and planning appropriately.

Collaborations to facilitate success of community pharmacy practice-based research networks.

OBJECTIVE: To describe the nature of the collaborations between academia and practitioners in two community pharmacy practice-based research networks (PBRNs). SETTING: Community pharmacy practice sites owned by two pharmacy chain corporations that have cooperated with two pharmacy schools for up to 10 years in research efforts. PRACTICE DESCRIPTION: A PBRN is a group of community pharmacy practice sites that are affiliated with an academic institution(s) that investigate questions related to community practice. PRACTICE INNOVATION: A model of collaboration between academia and community pharmacy practice to enhance PBRNs. Collaborators in academia include practice and science faculty. Collaborators in community pharmacy practice include practitioners and practice-site decision makers. MAIN OUTCOME MEASURES: The role of each collaborator in the PBRN, suggestions for developing and maintaining collaborations among PBRN members, strategies to identify collaborators and to expand a PBRN, and the value to each collaborator of participating in a PBRN. RESULTS: Academically based pharmacy faculty members connect with practice sites and listen to the needs of practitioners in an effort to design research that will solve practice problems. Practitioners and practice-site decision makers need to understand the role of research in solving projects, propose problems to be addressed and methods to address them, and become committed to completing the research. Building partnerships among collaborators is an important step in developing and maintaining the pharmacy-based PBRN. For faculty members, the value is connecting with community practice, helping to solve problems, and sharing results with the pharmacy community. For practitioners, the value of collaboration centers on improving practice and expanding their professional role. CONCLUSION: The involvement of community pharmacy sites with PBRNs has the potential to be a driving force in practice innovation, improving patient care and professional satisfaction.