Targeting adaptability to improve Medication Therapy Management

Nov 27, 2019 | Hohmeier

OBJECTIVES: 1) To develop an adaptation framework for MTM delivery for pharmacists the MTM Adaptability Framework) 2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on MTM completion rates over a 2-year period and 3) to explore pharmacists’ perceptions regarding knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention.

METHODS: This study is a prospective mixed-methods research study including a quasi-experimental one-group pretest-posttest quantitative study with a sequential explanatory qualitative study arm featuring semi-structured key informant interviews. US supermarket pharmacy chain setting included 93 community pharmacy sites located in Tennessee Kentucky and Alabama. MTM completion rates are reported as percentage of completed comprehensive medication reviews CMRs) and targeted medication reviews TMRs) and pharmacist perceptions.

RESULTS: An 11.4% absolute increase in MTM completion rates was seen after the educational intervention targeting adaptation of MTM in the community pharmacy setting. This was found to be significant 46.92% vs. 58.3%; p < 0.001). Responses to the semi-structured interviews were mapped against CFIR and included themes: “knowledge and beliefs about MTM pre-intervention) self-efficacy for MTM implementation pre-intervention) knowledge and beliefs about MTM post-intervention) and self-efficacy for MTM implementation post-intervention).” Data convergence was found across these methodologies and suggested that targeting adaptability of MTM delivery increases MTM completion rates quantitative data) and positively changes perceptions of MTM feasibility and self-efficacy interviews).

CONCLUSION: The use of an educational intervention about adaptation of MTM to influence adaptation of MTM to a chain community pharmacy setting part of an implementation strategy improved MTM completion rates significantly. Future research should investigate combined implementation strategies and their impact on MTM implementation success.

PubMed Abstract

Hohmeier K. C. W. J. S. Turner K. Vick J. S. Marchetti M. L. Crain J. Brookhart A. 2019). Targeting adaptability to improve Medication Therapy Management MTM) implementation in community pharmacy. Implement Sci141) 99. doi:10.1186/s13012-019-0946-7