2 MedsCheck and Diabetes MedsCheck services explained
2.1 MedsCheck and Diabetes MedsCheck
The MedsCheck and Diabetes MedsCheck programs are in-pharmacy, patient centred services delivered by pharmacists. They are funded by the Department under the Medicine Use Review and Diabetes Medication Management services respectively as part of the 5CPA.
Medscheck and Diabetes MedsCheck services consist of a face-to-face medication check delivered by community pharmacists to patients who fit the eligibility criteria. This involves the pharmacist sitting down with the patient in a private area of the pharmacy and going through their medications. Figure 2.1 contains a brief description of the aims of the MedsCheck and Diabetes MedsCheck consultations.
A logic map depicting the aims and objectives of the services, together with a description of the inputs, outputs and desired outcomes is presented in Table 2.1. A service delivery map is in Figure 2.2.
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Figure 2.1: MedsCheck and Diabetes MedsCheck programs
Table 2.1: MedsCheck and Diabetes MedsCheck Program Logic
Medication Management Programs
MedsCheck
• The ‘MedsCheck’ service is a Medicines Use Review (MUR) provided by pharmacists to patients in a community pharmacy who meet an eligibility criteria.
• The MedsCheck service has the following aims, to:
– Help patients learn more about their medicines including interactions between medicines and disease states;
– Identify problems that patients may be experiencing with their medicines;
– Improve the effective use of medicines by patients;
and
– Encourage and educate patients about the best practice use and storage of their medicines.
• Funding = $29.6 million over 5 years of the Fifth Community Pharmacy Agreement (5CPA).
Diabetes MedsCheck
• ‘Diabetes MedsCheck’ is a Diabetes Medication Management Service provided by pharmacists to patients with type 2 diabetes who are newly diagnosed (within the past 12 months or whose diabetes is less than ideally controlled.
• Diabetes MedsCheck is delivered in a community pharmacy and is targeted towards patients who are unable to gain timely access to other diabetes services in their community.
• The Diabetes MedsCheck service has the following aims:
– Optimise patients effective use of medicine through improving understanding of, and compliance with, their diabetes medication therapy;
– Improve patients effective use of blood glucose monitoring devices through training and education;
– Improve blood glucose control; and
– Reduce the risk of patients developing complications associated with type 2 diabetes.
• Funding = $12.2 million over 5 years of the 5CPA.
Goal To enhance the quality use of medicines by patients living in the community and therefore optimise health outcomes, and to reduce adverse events related to medication misadventure.
Objectives MedsCheck objectives
To optimise the effective use of medicines within the community through improving the understanding of how medications affect medical conditions, and adherence with medication therapy.
Identify problems patients may be experiencing with medication/s; and Encourage best practice use and storage of medicines.
Diabetes MedsCheck objectives
Optimise effective use of medicines through improving understanding of, and adherence with, diabetes medication therapy;
Improve patient’s effective use of Blood Glucose Monitoring devices through training and education;
Improve Blood Glucose Control; and
Reduce risks of developing complications associated with Type 2 Diabetes through increasing adherence with their medication.
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Long term outcomes
Adverse events related to the use of medicines by patients’ living in the community who use multiple medicines and/or have had a recent significant medical event are reduced
Cost effectiveness (inputs per outcome): the MedsCheck programs achieve value for money (improved patient health and less wastage of medicines for a reasonable financial investment)
Medium term outcomes
Eligible patients learn more about their medicines including interactions between medicines and disease states.
Problems patients are experiencing, including adverse events with their medicines are identified and resolved where possible.
Medicines are used more effectively and stored correctly following the MedsCheck review.
An improvement in adherence with medications is observed.
Outputs A report which is easy to understand by patients is provided to eligible clients in accordance with program guidelines and contains:
A patient medication chart and pharmacist recommendations that may arise from the service;
and
information for the patient or pharmacist to take to another health professional as required and consented to by the patient or representative.
A record of service is submitted for audit purposes and to enable payments.
Payments are made in a timely way to pharmacists by the Department for services rendered.
The program is administered efficiently (inputs per output).
Activities The MedsCheck services are targeted towards people living in the community who are most in need of assistance with their medicines and who are able to access community pharmacies i.e.
the services are targeted to appropriate clients
The number of HMR(s) performed decreases as patients’ whose needs are met more appropriately through MedsCheck and Diabetes MedsCheck are redirected to these community pharmacy services.
The community pharmacist completes an Assessment Tool confirming the eligibility of the patient and enabling a report to be provided to the patient.
The services are client oriented and delivered with respect for patient dignity, culture, geographic diversity, confidentiality, and promptness.
Inputs Department of Health and Ageing resources.
IT systems effectively support pharmacists to deliver the program.
Skills and knowledge of community pharmacists are appropriate to deliver the program effectively.
Community pharmacists allocate dedicated time to the service — the pharmacists must not undertake any other professional duties at the time of the MedsCheck or Diabetes MedsCheck.
Infrastructure in the pharmacy so that a private counselling area can be provided.
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External influences which affect outcomes
The benefits of the program require patients to adopt the advice they receive from pharmacists.
The uptake of the service by patients and pharmacies may depend on support for pharmacists by other health practitioners such as GPs, i.e. lack of consistency in messages received by patients may limit the uptake of the MedsCheck service.
Program sustainability: Population demographics and epidemiology of the relevant populations (e.g. people with diabetes) may change over time thereby influencing the numbers of eligible participants.
Advances in IT dispensing systems may lead to some processes embedded in the MedsCheck reviews becoming redundant.
The availability of other 5CPA programs may influence the uptake of MedsCheck and Diabetes MedsCheck as they may be easier to administer and offer alternative streams of income.
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Figure 2.2: MedsCheck/Diabetes MedsCheck service delivery map