TY - JOUR
T1 - Qualitative analysis of telephonic comprehensive medication review content and delivery
AU - Dhatt, Harman
AU - Vaffis, Shannon
AU - Le, Darlena
AU - Axon, David R.
AU - Campbell, Patrick J.
AU - Black, Heather
AU - Kolobova, Irina
AU - Nelson, Mel L.
AU - Warholak, Terri
N1 - Funding Information:
Disclosures: Harman Dhatt received funding from Tabula Rasa Healthcare Group outside this study. Shannon Vaffis received funding from Roche and Tabula Rasa Healthcare Group outside this study. Darlena Le received funding from Xcenda outside this study. Patrick J. Campbell, Heather Black, and Irina Kolobova are employed by Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc, Kenilworth, NJ, USA. Patrick J. Campbell was employed by Pharmacy Quality Alliance at the time of the study. David R. Axon received funding from the American Association of Colleges of Pharmacy, Arizona Department of Health Services, National Council for Prescription Drug Programs, and Tabula Rasa Healthcare Group outside this study. Mel L. Nelson is employed by Pharmacy Quality Alliance. Terri Warholak received funding from Arizona Department of Health Services, National Council for Prescription Drug Programs, and Tabula Rasa Healthcare Group outside this study. The authors declare no other relevant conflicts of interest or financial relationships.
Funding Information:
Funding: This study was funded under a collaborative agreement by Merck Sharp & Dohme Corp , a subsidiary of Merck & Co, Inc, Kenilworth, NJ, USA.
Publisher Copyright:
© 2022 American Pharmacists Association®
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Comprehensive medication reviews (CMRs) are offered to eligible Medicare beneficiaries to improve patient medication knowledge, identify, and address medication concerns, and empower medication self-management. However, the specific content of real-world CMRs is unclear. Objective: To qualitatively assess CMR content and delivery among telephonic CMR providers. Methods: This qualitative thematic analysis used transcriptions of audio-recorded patient interactions during CMRs from 3 telephonic medication therapy management provider organizations. Data were qualitatively analyzed using the inductive saturation model to code emergent themes by independent reviewers who met to agree themes through consensus. Intercoder reliability was calculated using Krippendorf alpha. Results: Overall, 32 CMR transcripts from 3 organizations were analyzed in 13 rounds of coding. Intercoder reliability was >95%. A total of 21 themes were identified across 4 stages: call opening (4 themes), medication reconciliation (5 themes), clinical assessments and guidance (8 themes), and call closing (4 themes). The call opening stage included: service explanation; insurance coverage/cost; identity/privacy/recording; and patient's medication management. Medication reconciliation included: drug name, dose, frequency, and indication; medication deletion and addition; over-the-counter and vaccination assessment; drug efficacy assessment; and prescribing provider assessment. Clinical assessments and guidance included 4 core clinical assessments: allergy assessment; drug therapy problem assessment; drug-related adverse events; and medication modification; and 4 additional assessments: clinical/therapeutic guidance; cost savings guidance; diet/exercise/lifestyle guidance; and optional clinical and behavioral assessments. Call closing included: documentation; primary care provider confirmation; patient satisfaction; and call transfer. There were variations among organizations in the depth that CMR components were covered. Conclusion: These findings suggest provider organizations are including components that meet Centers for Medicare and Medicaid Services goals for CMRs. Yet, variations among organizations indicate a need for standardization and patient-centered measures to ensure appropriate CMR components are covered, while maintaining flexibility for pharmacists to provide patient-oriented CMRs that meet patients’ clinical needs.
AB - Background: Comprehensive medication reviews (CMRs) are offered to eligible Medicare beneficiaries to improve patient medication knowledge, identify, and address medication concerns, and empower medication self-management. However, the specific content of real-world CMRs is unclear. Objective: To qualitatively assess CMR content and delivery among telephonic CMR providers. Methods: This qualitative thematic analysis used transcriptions of audio-recorded patient interactions during CMRs from 3 telephonic medication therapy management provider organizations. Data were qualitatively analyzed using the inductive saturation model to code emergent themes by independent reviewers who met to agree themes through consensus. Intercoder reliability was calculated using Krippendorf alpha. Results: Overall, 32 CMR transcripts from 3 organizations were analyzed in 13 rounds of coding. Intercoder reliability was >95%. A total of 21 themes were identified across 4 stages: call opening (4 themes), medication reconciliation (5 themes), clinical assessments and guidance (8 themes), and call closing (4 themes). The call opening stage included: service explanation; insurance coverage/cost; identity/privacy/recording; and patient's medication management. Medication reconciliation included: drug name, dose, frequency, and indication; medication deletion and addition; over-the-counter and vaccination assessment; drug efficacy assessment; and prescribing provider assessment. Clinical assessments and guidance included 4 core clinical assessments: allergy assessment; drug therapy problem assessment; drug-related adverse events; and medication modification; and 4 additional assessments: clinical/therapeutic guidance; cost savings guidance; diet/exercise/lifestyle guidance; and optional clinical and behavioral assessments. Call closing included: documentation; primary care provider confirmation; patient satisfaction; and call transfer. There were variations among organizations in the depth that CMR components were covered. Conclusion: These findings suggest provider organizations are including components that meet Centers for Medicare and Medicaid Services goals for CMRs. Yet, variations among organizations indicate a need for standardization and patient-centered measures to ensure appropriate CMR components are covered, while maintaining flexibility for pharmacists to provide patient-oriented CMRs that meet patients’ clinical needs.
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U2 - 10.1016/j.japh.2022.11.006
DO - 10.1016/j.japh.2022.11.006
M3 - Article
C2 - 36481091
AN - SCOPUS:85143875626
SN - 1544-3191
VL - 63
SP - 555
EP - 565
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 2
ER -