Download Medication Management Services in Community Pharmacy

Diabetes MedsCheck
The MedsCheck services are funded by the Australian
Government Department of Health and Ageing as part of
the Fifth Community Pharmacy Agreement.
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
MedsCheck and Diabetes Medscheck
• One-on-one consumer consultation with a pharmacist
• ‘Consumer-Centric’ service, identify medication issues
and tailor individual advice
• Increase consumer knowledge about prescribed
medications and encourage Quality Use of Medicines
(QUM)
• Increase consumer confidence in taking prescribed
medications + increased compliance = better health
outcomes
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Program Specific Guidelines
• Pharmacy eligibility;
– Approved Section 90 Pharmacy
– Service performed by a registered
pharmacist
– Consulting pharmacist performing
MedsCheck is not responsible for
dispensing or undertaking other
professional duties at the time of the
in-pharmacy review
5cpa.com.au/medscheck > Guidelines
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Program Specific Guidelines
• Pharmacy eligibility:
– Have a screened area or separate room that is distinct
from the general public area of the pharmacy that;
• Allows for confidential ‘sit-down’ appointments
• Allows Pharmacist and consumer to talk at normal volumes
without being overheard
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Program Specific Guidelines
• Consumer eligibility requirements – Diabetes
Medscheck
Consumer has not had a Medscheck, Diabetes MedsCheck,
HMR or RMMR in the past 12 months
and
Consumer is living at home in a community setting and
holds a valid Medicare or DVA card
and
Consumer has Type 2 Diabetes
Recently diagnosed (last 12 months) OR has less than ideally
controlled diabetes
AND
 Has an inability to access existing diabetes services in the
community, in a timely manner
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Program Specific Guidelines
• Consumer Eligibility Requirements - MedsCheck;
 Consumer has not had a Medscheck, Diabetes MedsCheck, HMR
or RMMR in the past 12 months
and
 Consumer is living at home in a community setting and holds a
valid Medicare or DVA card
and
 Consumer takes 5 or more prescription medications
or
 Consumer has experienced a recent significant medical event
 Acute event, exacerbation of chronic disease/condition
 Recent hospital admission, new diagnosis
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Documentation and Recording
Requirements
• Ensure that you have the consumers consent
• Ensure you have the consumer’s signature on the MedsCheck
claim form
• Complete a consumer report, ensure that recommendations are
documented and discussed with the consumer
• Ensure that information is gathered/documented to support
submission of the MedsCheck payment application form (i.e.
chronic conditions)
• Ensure that records are stored appropriately and accessible for 7
years
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Documentation and Recording
Requirements
• Records to keep may include;
– A copy of your claim for payment
– A copy of any MedsCheck program payment
application form(s)
– A copy of the MedsCheck consumer report
(which includes Medicine List and Action
Plan) - electronic or otherwise
– Any other material which may be relevant
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Professional Practice Guidelines
• Developed by the
Pharmaceutical Society
of Australia (PSA)
• Available for all
pharmacists to access
through
www.5CPA.com.au
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Quality Care Pharmacy Program
(QCPP) Requirements
• QCPP Checklist and Fast-Track
documents available to
support pharmacies
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Implementing Medscheck
and Diabetes MedsCheck
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
The right service, for the right consumer….
MedsCheck/Diabetes MedsCheck
Home Medicines Review (HMR)
Must be conducted in the Community Pharmacy
Requires GP referral
•
Identifies consumer is at risk of medication
misadventure due to:
• Prescription of a medicine requiring
therapeutic monitoring,
• The complexity of their medication
regimen,
• The characteristics of their medicine,
• Presentation of symptoms suggestive
of an adverse drug reaction, and/or
• A sub-therapeutic response to therapy.
Aim: to resolve actual or potential
medication-related problem(s) and
optimise therapeutic outcomes
Identifies that the consumer may be
experiencing problems with
managing and/or adhering to their
medicines;
• Determines the consumer would
benefit from learning more about
their medicines and requires
improvement in the effective use of
their medicines; and/or
• Determines the consumer requires
education and assistance on how to
best use and store their medicines.
Aim: to educate and inform and
improve medication compliance
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Identifying consumers
• Make use of the MC/DMC Service Checklist
• consumers with hospital scripts or discharge
summaries.
• consumers who reach their safety-net.
• Utilise existing and upcoming IT resources to
improve efficiencies
– MedScreen (GuildCare)
– DAA Detect (GuildCare) – dispensary analytics
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Service Checklist and
Eligibility Screening Tool
5cpa.com.au/medscheck
Use either of the above resources to assist with determining consumer eligibility
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Synergies and integration with
existing Pharmacy Services/Incentives
• Pharmacy Practice Incentives:
– Clinical Interventions
– Dose Administration Aids (DAA)
– Primary Healthcare – Disease State Management
– Working with others
• Consumers who have been involved in the
above pharmacy services, may benefit from a
MedsCheck
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Integrating the Service
• Counseling Area;
– Private/comfortable for consumer
– IT access for pharmacist (dispense records,
GuildCare etc.)
– Access to Pharmacy resources for reference (AMH,
eMiMs, APF, CMI’s etc.)
– Information about other services – HMR
brochures, DAA brochures/example pack
– Medication dosing aid products – pill cutters,
doset boxes/caddies etc
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Considerations for Service
• Appointment system vs ‘Ad-hoc’ consultations
– important to be prepared for either service
• Appointments may give more structure to the
service, allows for pharmacy to structure staff
adequately
• Ad-hoc services may be beneficial for consumers
who may be hesitant about booking in
• Online booking systems?
• Specific store service/appointment times?
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Considerations for Service
• Whole team approach
• Utilize available resources and increase
efficiencies with IT enablement
• Many consumers who meet the eligibility
criteria welcome one on one time with a
pharmacist
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Promoting the Service
• In-store promotion materials (posters,
brochures, counter mats, in-store media etc.)
• Collaboration with local GP surgeries – make
them aware of the service
• Promote to consumers and carers
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Performing Medscheck
and Diabetes MedsCheck:
7 key steps!
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 1: Confirm Consumer Eligibility
• Utilize approved screening tool
• consumer lives at home (in the
community)
• 5 or more medications / recent
significant medical event?
• Type 2 diabetes?
– Recent diagnosis/recent change
to therapy/poorly controlled –
Diabetes MedsCheck
– Timely access to a diabetes
educator
• MedsCheck / HMR service in the
last 12 months?
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 2: Prepare for the Interview
• History review;
– Approximately 3 months dispense history (where
available)
– Any OTC/Complementary Medicines/Devices?
– Encourage consumer to bring in medicines/devices to the
consultation
• Alternatively – Use products from the dispensary whilst discussing
if performing the service ‘ad-hoc’
– Other relevant information: Hospital discharge summary
sheet, previous medication lists etc.
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 3: The Medicines Review
• Key points to review;
– consumer’s knowledge of prescribed medicines
• Is the consumer unsure of why medicines have been
prescribed?
• Does the consumer confuse the names/indications of
their medicines
• Does the consumer accurately understand the
prescribing instructions? (particularly P.R.N meds)
– What is the consumer’s perception of the
effectiveness of their medications?
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 3: The Medicines Review
• Key points to review;
– consumer compliance
• Does the consumer have any trouble
adhering to their medication schedule?
• What does the consumer do in the
instance of a ‘missed dose’?
• What is the consumers medication
taking routine?
– Barriers to compliance;
• Swallowing tablets? Dexterity? Device
technique?
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 3: The Medicines Review
• Key points to review;
– Adverse Drug Reactions (ADR’s)
• Suspected, potential, actual
– Consumer perceptions of ADR’s
• Does the consumer believe they are getting side effects from
any of their medicines? If so, what symptoms?
– Review for medication issues
• Duplications, unusual doses/regimes, drug-drug interactions,
drug-disease interactions
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 4: Provide Consumer Support
• Other points to consider;
– Simplification of medication regimes where
possible
– Provide dosing aids (cutters, dosette boxes,
spacers etc.)
– Check dates of medications that consumer brings
in (particularly PRN)
– Lifestyle considerations (smoking cessation,
alcohol, diet modification etc.)
– Provide Consumer Medicines Information (CMI)
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 5: Performing a Diabetes
MedsCheck
• Record the following clinical metrics;
– Blood Pressure (mmHg)
– Weight (Kg), Height (Cm), Waist (Cm)
– Optional – calculate BMI (Kg/m2)
• Discuss BGL monitoring;
– Does the consumer self monitor?
– Does the consumer have any issues with
device usage?
– Discuss recent hypo/hyperglycaemic events
• consumers education about nutrition and
diabetes?
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 6: Complete the Consumer Report
• Information to consumer;
– Develop a Medicines List for the consumer (eg. Patient
Medication Profile)
– Develop a written action plan
• Include agreed consumer goals and any agreed follow-up with the
consumers GP and/or other healthcare professional
– Provide consumer with a copy of the Consumer Report,
which includes the Medicines List and Action Plan
– Information about other beneficial pharmacy services that
may suit the consumer;
• DAA’s, DSM, HMR etc.
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 6: Complete the Consumer Report
• Medicines List: Key Elements
– Include details of all current regular and ‘prn’ medicines (prescription,
non-prescription and complementary)
– Short term medicines (i.e antibiotics, cold/flu treatment) may be
excluded from the list
– Document any known drug allergies or ADR’s
• Include the following;
–
–
–
–
–
Active Ingredient
Brand, Strength, Form
Prescriber details
Frequency, Duration of treatment
Indication, Special instructions
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 6: Complete the Consumer Report
• Written Action Plan: Key Elements
– Document consumer issues that arise during the
MedsCheck
– Outline outcomes and recommendations for the
consumer
– Specify who is to consider outcomes and
recommendations
• i.e: consumer, pharmacist, GP, other healthcare provider
– Set review date(s) and agree upon goals with the
consumer
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Step 7: Consumer Follow-up
(post-MedsCheck)
• Arrange agreed follow-up actions, which may
include;
– Contacting the consumers GP or other healthcare
provider(s)
– Providing a copy of the Medicines List and/or
Action Plan to the consumers GP or other
healthcare provider(s)
– Request to GP for further review if necessary
(HMR etc.)
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Performing Medscheck and
Diabetes MedsCheck:
Support tools
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Consumer Report Templates
Medicines List
Source: Guidelines for pharmacists providing medicines use review and diabetes medication management services I © Pharmaceutical Society of
Australia Ltd. I July 2012
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Consumer Report Templates
Action Plan
Source: Guidelines for pharmacists providing medicines use review and diabetes medication management services I © Pharmaceutical Society of
Australia Ltd. I July 2012
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
Dispensary Pop-Up
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
Eligibility Criteria – Screening Tool
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
Pre-Populated
fields;
-consumer
-Medicine
-Prescriber
-Etc.
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
Consumer Report:
Medication List
Consumer Report:
Action Plan
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
Printable forms;
-Eligibility Criteria
-Consumer handout
-Consumer report
(meds list + action
plan)
-Blank worksheets
(manual template)
Payment Claim
form;
-Pre-Populated
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
IT Enablement: GuildCare
• Re-subscription: www.guildlink.com.au
• The GuildCare MC/DMC module will include all the benefits of
current GuildCare programs:
• Seamless integration with the dispensing software
• No need to re-key consumer details
• In-built prompts for consumer who may qualify for MedsCheck or
Diabetes MedsCheck
• Automatically populates consumer & claim forms
• Ability to print meaningful reports for:
– Consumer - the report for the consumer will include Patient Medication
Profile including the image and information about the medicine
– GP - Report with all requirements as stipulated by 5CPA Program Specific
Guidelines (MedsCheck/Diabetes MedsCheck)
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Keeping your MedsCheck services
on track
Four key tips for helping keep your MedsCheck
services on track:
1. Target consumers for which your pharmacy has
established medication management records
2. Ensure ALL required consumer details are
correct on the payment application
3. Ensure your MedsCheck pharmacist(s) are
registered with DHS (Medicare)
4. Submit your MedsCheck service claims
MONTHLY
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Resources and Information
www.5cpa.com.au
– Program Specific Guidelines
– Professional Practice Standards
– MMR Service provider application form
– MedsCheck coversheet and claim form
1300 555 262
[email protected]
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
KYN Registration Log
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice
Questions?
Lucky Zeniou
Pharmacy Guild of Australia, QLD
E: [email protected]
P:07 3831 3788 M:0448 058 892
Diabetes
MedsCheck:
A Step-by-Step
Integrating
Professional
ServicesGuide
in Pharmacy Practice