Medication Management Center

Medication Management Center

Drachman Hall B306

Doctor of Pharmacy APPE

Site:

The Medication Management Center (MMC) is a one-of-its-kind patient care center founded in 2006. We provide MTM services to patients across the country via phone through contracts with patients’ health plan, PBM or employer group. Our center is staffed with almost 100 people, including 16 pharmacists, 20 technicians, and 50 interns.

Site phone number (520) 626-2701

Preceptors:

Nicki Scovis, PharmD, BCPS, BCACP / 626-3282 / 6:30-3:00 /
Jason Reddick, PharmD / 626-3426 / 6:30-5:00 /
Robert Lipsy, PharmD, BCPS, FASHP / 626-3963 / 8:00-4:30 /
Aimee Keller, PharmD / 626-3465 / 7:30-4:00 /

Hours: M-F 8:00-4:00

Time may have to be spent outside of these hours on studying, drug information, projects, presentations, etc.

Objectives:

Knowledge/Clinical:

·  Have a firm understanding of treatment guidelines for core disease states and be able to evaluate therapy and make recommendations based on patient interview and guideline recommendations.

·  Understand, explain, and provide education for core disease states.

·  Apply critical thinking skills to solve patient problems.

·  Identify special considerations for geriatric patients.

·  Become familiar with Medicare Part D and managed care concepts

Communication:

·  Effectively interact with patients to collect and provide information.

·  Effectively communicate and collaborate with other healthcare providers.

·  Provide presentations that are relevant, useful and without bias.

Professionalism:

·  Display a positive attitude and flexibility

·  Act as a patient advocate.

·  Prioritize patient problems and treat the whole patient within the time provided.

·  Manage time between patient care and other responsibilities.

Drug information:

·  Retrieve, analyze, interpret, and apply information from the scientific literature in order to solve patient problems.

·  Explain, critique, and make recommendations based on studies from the primary literature.

Other:

·  Demonstrate expertise in informatics.

Typical day:

This will vary by the rotation cycle.

Six hours per day will be spent on patient care, Comprehensive Medication Reviews (CMRs) or Targeted Medication Reviews (TMRs). Students will be expected to do 1 CMR per hour by the end of the rotation. This includes work-up, presentation to the preceptor, interview with the patient, SOAP note and provider communication.

Unscheduled time may be spent on working up patients, finishing SOAP notes or provider communication, projects, drug information or other projects assigned at the pharmacists’ discretion.

Dress Code: Business Casual.

Confidentiality / HIPAA:

All aspects of HIPAA and the HITECH Act must be followed. The following are examples of how this applies to this practice site.

·  Printed/written information with PHI must be shredded after use.

·  PHI may not be taken home.

·  PHI should not be included on handouts for presentations.

·  Workstation must be locked when unattended (CTL-ALT-DEL).

·  Temporary documentation (SOAPs, patient plans, faxes, presentations) may only be saved in Q:\PharmPractice\MedicarePtD\Pharmacists+Interns(MP)\APPE (NS)\Temporary documentation

Statistics, outcomes, payment structures and issues concerning business practices with various clients are confidential and should not be disclosed to anyone outside of the MMC. Dr. Boesen can provide additional guidance if there are questions about what information can be shared.

Academic Honesty:

It should go without saying that you will conduct yourself as a professional and will honor the academic honesty policy as set forth by the University of Arizona College of Pharmacy.

Absence Policy:

Absence policy will follow that set forth by the University of Arizona College of Pharmacy Rotation Manual. Any tardiness or absence should be communicated to Nicki and the preceptor of the week at the numbers listed in the syllabus.

Grading Policy:

Evaluations will be completed at the intervals prescribed by the University of Arizona College of Pharmacy. Specific feedback will be given informally throughout the rotation and formally at each of the evaluations. Student feedback is encouraged at all points and will be directly solicited at evaluations.

Grade recommendations and feedback will be a collaborative process between all preceptors, taking into account patient interaction, critical thinking skills, presentations/projects and goals for the rotation (see above). Other staff feedback will also be considered.

A failing grade FOR THE ROTATION will be given for any student who:

·  Contacts a scheduled CMR patient without presenting to a pharmacist first

·  Contacts a CMR patient’s physician to make recommendations without review by a pharmacist prior.

PATIENT CARE: Medication Therapy Management (MTM):

Comprehensive Medication Review (CMR) patients are interviewed via telephone and control of disease states, appropriateness of therapy, problems with therapy and cost issues are addressed. Most patients are Medicare Part D MTM-eligible based on projected drug spend, number of medications and conditions. Some patients may be eligible for services as part of a non-Medicare program. Patient appointments are scheduled as they are requested by patients.

Student Role:

1.  Work up the patient

2.  Present to the preceptor prior to calling.

3.  Conduct patient interview

4.  Complete documentation including patient plan, SOAP and provider communication.

5.  Have the preceptor review patient plan and provider communication prior to sending.

Core disease states:

Diabetes ADA

Hypertension JNC VII

Dyslipidemia ATP III, ATP III update

Asthma GINA, EPR 3

COPD GOLD

Heart failure ACCF/AHA

CAD ACC/AHA, CHEST

Chronic pain AGS, APS

PROJECTS:

1.  Therapeutics reviews:

There are several formal disease state reviews. Reviews are guided by question sets located on the shared drive. These must be completed prior to the review. Current clinical guidelines should be used for review of disease states, not therapeutics class notes, text books or other sources. Students should be prepared to answer any questions from the guidelines and to apply them to patient cases.

In addition, there will be one or two interactive presentations on Geriatrics-related topics. These will not have a question set, but may include patient case workup ahead of time.

2.  Drug Information:

Drug information questions will come up from time to time and may be assigned at the preceptors’ discretion. Review articles, textbooks, guidelines or tertiary sources should not be used to answer the drug information questions although these sources can be helpful for developing the introduction.

Responses should have four primary sections:

1.  An introduction or background.

2.  Findings from the literature review including a synopsis of each pertinent study with any inadequacies or deficiencies noted.

3.  Recommendations or conclusions to answer the request.

4.  References in AJHP format

PRESENTATIONS:

Handouts will be required for each presentation. Expect to have 5-10 copies of handouts, slides, articles, etc for presentations. Always put your name on handouts!

1.  Case presentation:

Use SOAP note format. This is an informal presentation followed by extensive discussion. Students should be able to anticipate questions and cite sources. NO PHI on handouts!

2.  Journal Club:

Reviewing the medical literature is a difficult, but important skill and one that must be practiced. It is up to the student to choose an article to present for journal club.

This article should be (1) original research, (2) published within the last year

(3) applicable to our patient population or the Center, and (4) published in a reputable journal.

Make sure that you clear your article with one of the preceptors and that each of the pharmacists receives a copy of your article by the deadline on the schedule.

For your handout, use the template provided on the shared drive. When journal articles are reviewed, information from the study should be presented first and then critiqued. It helps to refer to figures or tables in the article to illustrate important points as the article is reviewed. The goal of journal club is to have recommendations on how to apply results to our practice. The template is a brief take-away for participants, not a guide for the presentation.

3.  Final Presentation:

This is a 20-minute formal PowerPoint presentation. The handout is your slides. You will choose the topic. It must be approved by one of the preceptors and must be applicable to our patient population and/or practice setting. A laptop is necessary for the presentation. You can bring one or Christine can loan one out if needed. Center laptops have no wireless access and can only be connected through the VPN. All presentation rooms are equipped with a projector, screen and white board. Set up in the designated room so that you are ready to go at presentation time. If you are having computer or audio-visual trouble, ask for help.

Format may vary by presentation topic, but the following are required slides:

(1) Objectives

(2) Take-away

(3) References