Development & Implementation of the Technology-Enabled Alliance for Medication Therapy Management (TEAM)
November 2018 – October 2021
Gordon and Betty Moore Foundation
We will link community pharmacy and primary care practices via a shared electronic health record to improve medication therapy management for older patients taking complex prescription regimens. This study aims to 1) evaluate the fidelity and efficacy of the TEAM intervention to promote healthcare provider counseling, medication reconciliation, and safe regimen use among adults taking complex Rx regimens; 2) explore patient, healthcare provider (pharmacist, prescriber), community pharmacy and/or primary care practice barriers to implementation; and 3) determine the costs of the TEAM intervention from both a community pharmacy and primary care practice perspective.
Primary care practices in the U.S. are increasingly challenged to manage the growing number of patients living with multiple chronic conditions. Despite this, clinicians have difficulty identifying and addressing the risk for potential medication errors, and few clinical resources exist to support and monitor patients’ Rx use at home. As a result, poor adherence and medication challenges often go unrecognized and untreated. We will develop, implement and field test the TEAM strategy through a partnership with a large, multi-site Federally Qualified Health Center (FQHC) in Chicago and a national retail pharmacy chain. The TEAM intervention will connect the community pharmacy to the FQHC via an electronic health record (EHR), allowing shared access to patients’ medical records. The TEAM strategy enables a community pharmacist to help patients on complex Rx regimens via: 1) Read/Write Access to the EHR enabling pharmacists to review and edit patient records; 2) Medication Review conducted by designated pharmacists to evaluate reconciliation, proper use and address patient-related concerns; 3) EHR Rx Adherence Alerts and Reports directed to the provider alerting them if a patient has not filled an Rx within 2 weeks of the order, and a 6-month adherence report detailing adherence per medication; 4) Clinical Decision Support provided by the pharmacist via secure, EHR-based messaging to notify providers of any medication concerns including special recommendations to expedite action. The TEAM trial presents an innovative approach to primary-care based medication therapy management by linking community pharmacies to resource constrained FQHCs. We aim to provide a multi-faceted strategy to improve long-term medication management leveraging readily available technology with minimal disruptions to the clinical workflow.
• Principal Investigators: Michael S. Wolf, PhD MPH; Stacy Cooper Bailey, PhD MPH
• Project Lead: Sarah Wozniak