Practice Transformation
When the VA transitioned pharmacist-led outpatient CMM clinics to all-virtual care, the consistency and quality of care was not compromised; in fact, the program saw more patients and documented more encounters, and the no-show rate dropped. The findings were published in the Journal of The American College of Clinical Pharmacy. “[T]his is a positive discovery regarding the potential future direction of CPS [clinical pharmacy specialists] provided direct patient care in telemedicine while preserving exceptional quality of care.” (Journal of The American College of Clinical Pharmacy)
Evidence & Innovation
Establishing a common language for the CMM patient care process ensures consistency and establishes expectations across stakeholders. Unfortunately, CMM is often “poorly understood, not well defined, and lacks a measure of fidelity,” researchers write in the Journal of The American College of Clinical Pharmacy. To address that challenge, a framework and a common set of essential functions and operational definitions to “guide the implementation of CMM delivery in primary care and facilitate replication, scale, and positive impact” was created. (Journal of The American College of Clinical Pharmacy)
The amount of prescription drugs given to children in the US dropped by 27.1% between April and December 2020, compared with the same period in 2019, according to research published in Pediatrics. “Declines were greater for infection-related drugs than for chronic disease drugs. Decreased dispensing of the latter is potentially concerning and warrants further investigation. “The big question that needs to be answered: Is this just a pandemic-related blip, or something more lasting? (Pediatrics; Medscape Medical News)
American Society of Health System Pharmacists recently released the ASHP COVID-19 Vaccine Confidence Toolkit. It’s designed to help health care professionals, including pharmacists, student pharmacists and pharmacy technicians, to build vaccine confidence among their team, patients and community. The toolkit consists of four pillars representing key stages of building vaccine confidence: prepare, promote, provide and partner. The final pillar includes recommendations from the GTMRx Task Force. (ASHP Toolkit; Partner section)
Primary care teams help stroke patients recover as quickly as possible, according to a scientific statement from the American Heart Association and American Stroke Association. “Primary care teams provide the majority of post-stroke care. When optimally configured, these teams provide patient-centered care to prevent recurrent stroke, maximize function, prevent late complications, and optimize quality of life.” Walter N. Kernan, MD, chair of the writing group, elaborated: “Primary care professionals can ensure consistent and comprehensive care for the full needs of patients, including coordinating any additional care or services patients may need from community services providers or from subspecialty health care providers.” (Cardiovascular Business; Stroke; prepared statement)
Policy Solutions
Congress has the opportunity for meaningful drug pricing reform, but time is running out, according to a letter from dozens of purchaser, health care and employer groups. The signatories, which include the National Alliance of Healthcare Purchaser Coalitions, the UAW and Families call on Congress to empower Medicare and HHS to negotiate drug prices, install price-hike limits and redesign Medicare Part D to slash costs for beneficiaries and taxpayers. “Congress has a unique and time-limited window for crafting meaningful drug pricing reform this year.” (Fierce Pharma; the letter)
Some associations are starting to promote vaccine mandates, Modern Healthcare reports. The Association of American Medical Colleges recently stated that medical schools and teaching hospitals should require their workers to get the COVID-19 vaccine. Late last month, the Association for Professionals in Infection Control and Epidemiology threw its support behind mandates. More health systems are requiring their workers to get inoculated, but most medical associations have yet to make the recommendation. AHA has also recently joined in the support for mandatory vaccination. (Modern Healthcare*; AHA)
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In Case You Missed It!
Medicine is how we treat most conditions: Roughly 75%-80% of physician office and hospital outpatient clinic visits involve medication therapy. And more often than we would like, it is how disasters occur. More than 275,000 die each year because of medication misuse, overuse or underuse. The financial cost tops $528 billion annually, and employers are on the hook for a large portion of that.
Employers have the incentive, the leverage and the responsibility to change this. The evidence, best practices and tools are there to solve the systemic issues that lead to suboptimal medication use. Employers can lead the charge, through their contract authority and work with their suppliers, but they first must understand just how irresponsible doing nothing is. Download the issue brief for more.
We are sharing new survey results that assess the medication management habits and needs of over 1,000 people. Nearly one quarter of people cited that their medications are not routinely reviewed and evaluated by their medical team—shocking, given that one-third are taking four or more medications and/or supplements per day. The GTMRx Institute staff, workgroup and taskforce leaders and participants have created a set of tools to help inform and educate the consumers of health care services—and providers who have direct contact with the consumers—about why it’s important to get the medications right. We invite you to read more, share these tools and join us to ensure appropriate use of medications.
Leadership from GTMRx’s PGx Payment and Policy Taskforce and Payment and Policy Solutions Workgroup have created 5 policy recommendations on PGx + CMM that policymakers should consider to ensure that patient medications are managed safely and effectively based on the unique characteristic of an individual patients’ genetic profile, including:
- Add the assessment of patient medications and drug-gene interactions to Medicare (Welcome to Medicare visit) and Medicaid benefits,
- Require CMS to reimburse preemptive multi-gene panel testing as one single test with one standard compensation code,
- Require CMS to reimburse members of the care team trained to evaluate/manage all medications based on patient’s genotype, multi-drug interactions, Rx metabolism, etc.,
- Direct the National Quality Forum (NQF) to review and make recommendations on drug-gene interaction efficacy and safety checks prior/post admin of drugs within CMM,
- Recommend the U.S. Preventive Services Task Force evaluate evidence of PGx testing and CMM, for drugs with known drug-gene interactions, as a preventive health care practice that addresses patient outcomes/medical expenditures and that should be covered by ACA plans.
In addition to development of Vaccine Confidence Leagues (VCLs) and community-building activities, the task force’s recommendations include:
- Accelerated approval of vaccines
- Public education
- Payment reform
- Improved vaccine access for primary care practices
- More effective immunization information systems (IIS)
- No cost-sharing for certain patients
- Enhanced diversity, inclusion, and equity
Find the report Frequently Asked Questions here.
Read the report here.
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Adding the foundation on AmazonSmile will help us continue to provide no cost educational webinars, issue briefs, weekly news briefs and promote the need for transformation of our current system of medication use through social media campaigns.
