Author: Candace DeMatteis

 

The Patient Care Process for Delivering Comprehensive Medication Management (CMM) provides a common definition of comprehensive medication management (CMM) and common language to describe the patient care process for delivering CMM within primary care practice.  In the past, inconsistent definitions and implementation of medication management services have led to mixed results and limited the adoption of these services. With mounting pressure on clinicians to demonstrate value and reduce costs, having a common definition of CMM and what is involved in delivering CMM services with fidelity represents a significant breakthrough.

Supported by a grant from the American College of Clinical Pharmacy, Mary Roth McClurg, PharmD, MHS, Professor and Executive Vice Dean, UNC Eshelman School of Pharmacy, and Todd Sorensen, Pharm D, Professor and Associate Department Head, University of Minnesota College of Pharmacy, led a research team to design and test the CMM patient care process.  Thirty-five primary care practice sites across Minnesota, North Carolina, New York, and New Mexico provided “living laboratories” to test, define, and refine CMM.  Clinical pharmacists worked within those practices as a part of the care team.  The challenges faced, lessons learned, and best practices gleaned informed The Patient Care Process and overall framework for delivering CMM.  The research team also depended on insight and expertise in implementation science from Melanie Livet, PhD, and Caryn Ward, PhD to bring an evidence-based, rigorous approach to the development of The Patient Care Process and overall CMM framework.

“On behalf of the research team, we are excited to be releasing this common language document for CMM,” shared Roth McClurg. “We are also committed – through the development of a forthcoming technology platform and implementation system – to guiding teams through effective implementation and improvement of CMM,” she added.

The research team defines CMM as: “a patient-centered approach to optimizing medication use and improving patient health outcomes that is delivered by a clinical pharmacist working in collaboration with the patient and other health care providers.”  To operationalize that definition within primary care, researchers developed a conceptual framework and common language to describe three core components of care for CMM:

  • A Shared Philosophy of Practice – a shared set of professional values and beliefs that guides care team collective and individual actions and behaviors;
  • The Patient Care Process – the detailed nature of work that occurs with CMM; and
  • Practice Management – the structural and system level supports within a practice.

Each were defined, tested, and refined through working with the 35 primary care practices and the clinical pharmacists participating in the study.  The Patient Care Process is publicly available on the UNC Eshelman School of Pharmacy website.  This document includes an appendix that summarizes the core components of the CMM A Shared Philosophy of Practice.  The final component, Practice Management, will be released separately at a later date.

The Patient Care Process is intended to inform the care team about the CMM service to facilitate collaboration and understanding as to how CMM delivered by a clinical pharmacist is distinct from and complementary to patient care delivered by other members of the care team.  Establishing a common language for CMM allows care teams to understand how various members of the team contribute to a patient’s care that optimize medication use and improve outcomes.

Although these findings were based on research embedding a clinical pharmacist within a primary care practice, the patient care process for CMM may be easily adaptable to other care settings, including acute care, specialty practice, and community-based pharmacy practice.

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