A new study has looked at how pharmacy delivery of comprehensive medication management can help improve the carers’ work life
The study, published in the Journal of the American Board of Family Medicine, aimed to identify how the work life of primary care providers (PCPs) – including physicians, nurse practitioners and physician assistants – was impacted by these CMMs.
The researchers interviewed 16 PCPs, selected from four health systems in Minnesota, USA.
The lead investigator contacted the pharmacy managers of each health system to request their participation in the study, and asking the pharmacists to help them identify two to eight suitable PCPs to interview. Eight pharmacists identified PCPs and assisted in scheduling interviews.
Sites included in the study – which was part of a bigger CMM implementation and effectiveness project enrolling 36 primary care clinics across five US states – were required to have established CMM services delivered by pharmacists embedded in the primary care clinic.
They also needed to acknowledge that they were offering CMM in a manner consistent with definitions outlined within the American College of Clinical Pharmacy Standards of Practice for Clinical Pharmacists and the Patient-Centered Primary Care Collaborative Comprehensive Medication Management Resource Guide.
“Several themes emerged to describe the impact of CMM on PCPs’ work-life,” the authors wrote.
“When speaking of the pharmacist, PCPs spoke of them contributing a unique and complementary knowledge and skillset, as well as being a collaborative partner in caring for patients.
“They also described many positive outcomes of having CMM available that contribute to their work-life, as well as barriers and areas of opportunity that affect those outcomes.”
The pharmacists were seen as collaborative partners, whose provision of CMM “enabled them to work closely with another professional to care for patients and discuss care plans”.
“The PCPs felt this relationship led them to feel supported, reassured, and less burned out. In addition, PCPs felt the pharmacist helped reinforce treatment decisions, which could lead to greater patient agreement and acceptance, taking some of the burden off their shoulders.”
The PCPs also felt the pharmacists’ knowledge and skillset was complementary to their own, and that the pharmacists were knowledgeable about evidence-based guidelines and medications, making them a useful resources for questions about issues including medications, treatment options, and prescription insurance coverage.
They felt that having CMM available meant they could share some patient care and communication responsibilities, and that they felt their patients were receiving more comprehensive care when they could rely on CMM for some aspects of care around medication.
They also felt that the pharmacist-provided CMM helped them manage stress.
“PCPs felt that CMM decreased some of the pressure and mental/emotional burden of taking care of complex patients,” the authors wrote.
“They added that the assessment conducted during a CMM visit oftentimes helped to simplify and better organise the patient’s needs, so that their unresolved needs were easier for the PCP to address.”
CMM also improved patient access to care, they said, as patients could schedule a CMM for a medication-related need instead of visiting their PCP – and in many instances this is not subject to a copay.
The seven outcomes of having CMM available contributing to PCP work-life were listed as:
- decreased workload;
- satisfaction patients are receiving better care;
- decreased mental exhaustion;
- enhanced professional learning;
- increased provider access, and
- achievement of quality measures.
“Our findings suggest PCPs believe CMM, in general, positively affects their work-life,” the authors concluded.
“CMM’s impact on PCPs aligns with many previously identified drivers of burnout and engagement among providers.”
The study’s publication coincides with that of another international study which looked at the impact of a pharmacist intervention in general practice patients.
This study found that more than half of pharmacist recommendations advising changes to scripts were not actioned by GPs, with GPs giving reasons such as the recommendations being perceived as “more technical and unlikely to lead to patient benefit, such as switching the patient’s statin”.
Read the full US study here.