Through the Community-based Value-driven Care Initiative (CVCI), the Center for Medication Optimization is working to explore and evaluate the feasibility and effectiveness of four patient-centered, quality-driven care interventions delivered in community pharmacies. But first, the four innovative clinical interventions had to be selected. So, you may be curious, which four clinical interventions were chosen? Why these ones in particular? How were they picked over the many other possible interventions offered in community pharmacies? Were they selected at random? Maybe alphabetically? Let us find out!
A pre-defined process was outlined to identify and narrow down potential clinical interventions based on their innovativeness, effectiveness, feasibility, sustainability within community pharmacy, and impact on population health. This process included:
Conducting an environmental scan to identify potential initial community pharmacy intervention categories
Prioritizing the interventions found based on innovativeness, effectiveness, feasibility, sustainability and impact on population health
Conducting a targeted literature search to gain a thorough understanding of the potential priority interventions
Gathering feedback from experts
In the first step, an environmental scan was conducted to understand what clinical interventions are currently being delivered in community pharmacies. Information on these interventions was collected from two main sources:
Review of community pharmacies websites (chain store websites and the Community Pharmacy Enhanced Services Network (CPESN) website)
Google searches focused on innovative interventions and community pharmacy
Through the environmental scan, a total of 20 diverse types of clinical interventions were identified. Intervention areas of focus included HIV care, behavioral health support, opioid-related interventions and support, injections, care for minor ailments, comprehensive chronic disease programs, and others. The next step was to narrow this list down. To do so, all interventions were prioritized based on their overall level of innovativeness, level of feasibility, evidence of effectiveness, potential for long-term sustainability in community pharmacies, and overall impact on population health. Based on these criteria, eight interventions seemed particularly promising: (1) behavioral health support, (2) medication adherence, (3) comprehensive chronic disease programs, (4) screening and testing, (5) minor ailment care, (6) non-immunization injection administration, (7) HIV care, and (8) telehealth (remote monitoring and video conferencing) interventions.
A targeted literature search was then conducted to collect additional information on the eight remaining interventions. The purpose of this literature search was to dive deeper into the formal evidence around the impact of the interventions of interest, barriers and facilitators to implementing them, and sustainability mechanisms. This improved understanding of the interventions and how they are currently being implemented and sustained within the community pharmacy setting. Individual pharmacy experts were then engaged to provide additional feedback and insights on the interventions of interest.
The final step in the selection process was then to convene a panel of field experts to gather their feedback and facilitate selection of the final four interventions. The expert panel shared their experience implementing clinical interventions and offered input on which interventions they believed would be most effective, feasible, and impactful. With their additional feedback, the final four clinical interventions were selected:
Intervention toolkits to facilitate the high-fidelity implementation of these interventions within community pharmacies are currently being developed. Implementation of the interventions will begin in the Summer and Fall of 2021. You can find more details about the CVCI and an overview of the components included within each of these interventions here. For more project updates check back here and follow us on twitter @unc_cmo.