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Author: Candace DeMatteis

The lengthy delay between research discoveries and those discoveries actually benefitting patients is well known and much lamented.  Testing cause and effect can often lead researchers to control the environment of the study to the point that it doesn’t reflect reality in practice.  Such study designs allow the researcher to say intervention x caused result y definitively.  The ability to implement the intervention with fidelity and confidence of obtaining similar results in a real world setting, however, is lost.

Implementation Science, the study of methods to promote the adoption of research findings into routine healthcare delivery and settings, is changing that. UNC Post Doc Research Associate Carrie Blanchard, Research Assistant Professor Melanie Livet, and Associate Professor Mary Roth McClurg along with research colleagues at the University of Minnesota and the National Implementation Research Network are using implementation science to improve implementation of comprehensive medication management (CMM) in primary care settings. This project will document the critical factors for its successful implementation.

Optimizing the appropriate use of medications through CMM use holds significant promise in improving health and lowering costs.  After all, “medication misadventures” or the problems that arise from the misuse, underuse, and overuse of medication add up to $300 billion to healthcare costs annually in addition to avoidable burden on patients. Literature reviews of prior CMM research revealed that the studies defined CMM differently, if at all, limiting the ability for others to learn from and adopt best practices and replicate results.

In Research in Social and Administrative Pharmacy, Blanchard, Livet, Roth McClurg, and their co-authors describe their use of implementation science to develop a “roadmap” for defining and implementing Comprehensive Medication Management in primary care settings.  This roadmap describes a process that can be used to refine the implementation of CMM by primary care practice sites, and ensure success.

Achieving fidelity in the implementation of CMM will result in a consistent approach to CMM delivery that will facilitate replicability and scale-up in the real-world setting of a primary care practice.  Final results will not only provide evidence of how well CMM works, but also specifics on how interested primary care providers can build the intervention into their practices.

For more information about the innovative research underway at the Center for Medication Optimization through Practice and Policy, please visit our website.

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