Pharmacist Documentation of Medication Therapy Management Raises Concerns

A study comparing medication therapy management conducted face-to-face compared with over the phone revealed a troubling finding: low rates of assessment and plan documentation regardless of delivery method. Researchers published their findings online in Research in Social and Administrative Pharmacy.

“Pharmacists identify medication-related problems and provide education and medication reconciliation interventions independent of the mode of delivery,” researchers concluded. “The overall low frequency of assessment and plan documentation raises concerns.” 

The retrospective study looked at the types of medication-related problems, interventions, and documentation among patients receiving medication therapy management from community pharmacists in person vs over the phone. The study included all comprehensive medication reviews that occurred between 2011 and 2017 at 14 community pharmacies in Massachusetts that are part of a national chain. In all, 297 encounters were analyzed, 56.5% of which were conducted over the phone.

The study found no significant differences in medication therapy management that occurred over the phone compared with in person in the areas of clinical and demographic characteristics, types of medication-related problems, and pharmacist interventions.

While documentation for comprehensive medication review via phone was more common than for in-person encounters, rates for assessment and plan documentation were low: assessment was documented for 28% of in-person encounters and 42% of phone encounters, and plan was documented for 27% of in-person and 40% of phone encounters.

Meanwhile, discussion notes were documented in 97% of in-person and 98% of phone comprehensive medication review encounters. Pharmacist recommendations were documented in 92% of in-person and 95% of phone encounters. 

“It is imperative,” researchers wrote, “for pharmacists to document both instances of provider outreach and follow-up to ascertain resolutions of patients' medication-related problems.” 

—Jolynn Tumolo

Reference

Rivera J, Shcherbakova N, Vala C, Capoccia K. Community pharmacists' interventions and documentation during medication therapy management encounters delivered face-to-face versus via telephone: the devil is in the details [published online ahead of print December 26, 2019]. Res Social Adm Pharm. doi: 10.1016/j.sapharm.2019.12.020