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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