Positive deviants for medication therapy management: A mixed-methods comparative case study of community pharmacy...

Area of Science:

• Health Services Research
• Pharmacy Practice
• Quality Improvement

Background:

• Centers for Medicare & Medicaid Services (CMS) introduced Medication Therapy Management (MTM) services to optimize medication use in older adults.
• Understanding strategies for high-quality MTM outcomes is crucial for effective implementation within Medicare Part D.

Purpose of the Study:

• To generate hypotheses for strategies that contribute to high performance on policy-relevant MTM quality measures in community pharmacies.
• To identify key factors influencing the success of MTM services in a real-world setting.

Main Methods:

• A mixed-methods comparative case study utilizing the Positive Deviance approach and Chronic Care Model.
• Data collection involved semi-structured interviews with pharmacy staff and analysis of MTM quality measures mirroring Medicare Part D Star Ratings.

Main Results:

• Eight strategies were hypothesized to contribute to MTM performance, including strong staff-provider relationships, technician involvement, and prioritizing MTM.
• High performers utilized clinical information systems and specific communication methods with prescribers for medication therapy problems.

Conclusions:

• Hypothesized strategies can inform MTM practice and Medicare Part D policy to improve patient outcomes.
• Further research with larger, representative samples is recommended to validate these findings.