Randy P. McDonough

The ‘perfect storm’ may hit pharmacy

I have been extremely busy the past couple of months fi ghting to save my practice. As I have written in past columns, my partners and I have invested heavily in our practice to develop and implement new pharmacy services, including medication therapy management (MTM). As we work toward fair reimbursement for those services and recognition by payers as patient care providers, our dispensing service serves as the foundation of our practice, providing us with the economic support to expand into more innovative patient-centered services. Unfortunately, new reimbursement rates from pharmacy benefi t managers are threatening the viability of our practice.

Do you have the skills to practice contemporary community pharmacy

Recently, I was asked to give a presentation on our practice setting to a class of student pharmacists. As I was reviewing how our pharmacists perform continuous medication monitoring (CMM) services, one particular slide caught the attention of the course coordinator and the students—the skills required to perform CMM.

Who’s responsible for monitoring patients’ drug therapies?

Recently, I counseled a patient who had a serious adverse drug event(ADE) from a medication she had been on for several years. Thepatient had been diagnosed with Crohn disease and was started oninfliximab (Remicade—Janssen Biotech) infusions several years ago.Although infliximab reduced the patients symptoms, she developedfrequent upper and lower respiratory infections and eventually, chronicshortness of breath, dyspnea, and fatigue upon exertion.

Effectiveness of MTM interventions

Pharmacy has embraced medication therapy management (MTM) services as a strategy to improve patient drug therapy outcomes through the implementation of five core elements—medication therapy review, personal medical record, medication action plan, intervention/referral, and documentation/follow-up.

Build a successful practice using interprofessional communication skills

Building a successful medication therapy management practice requires pharmacists to communicate drug therapy problems to prescribers along with appropriate clinical recommendations to resolve the problems. Communication with other health care providers should be more than just transactional (i.e., in response to a problem). It should be relational so that a collaborative working relationship (CWR) is developed.

Make every encounter count

At a pharmacy conference this past July, I presented on the practice changes Towncrest Pharmacy has made in the past decade to focus our efforts on continuous medication monitoring (CMM). I explained to participants that we developed the CMM process because we felt strongly that pharmacists need to focus clinically on patients at every encounter, whether dispensing a new or refill prescription, answering health and/or drug-related questions in person or on the phone, providing a clinical service, or just giving a quick consult.

Call to action for all community pharmacists

As I was reading my e-mails one day this past month, I came acrossa message from Edward Bissler, Vice President of PharmacySupport at Mirixa Corporation. I assumed the message was a masse-mailing to all community pharmacies providing medication therapymanagement (MTM) services for patients who are eligible under theMirixa platform.

Is it really about quality

This past week, I came across an article in our local newspaper announcing a new partnership being formed in Iowa by a large insurer, a large health system, and a regional pharmacy chain. The article focused mostly on lower costs for policyholders who stay in network, but little on quality.

Advocacy: An essential skill for all pharmacists

Professionally speaking, this past year has been more challenging than any other in my career. A number of factors have affected our pharmacy, many beyond my control. In general, change is happening quickly in our profession—faster than at any other time in my career. And change can be intimidating and daunting, especially when it is rapid. In our pharmacy, change happened so fast, with drastic reductions in reimbursement, that I no longer had a clear vision of my future or that of our practice.

Prescription incentives: Concern for patient safety

I recently saw an ad in our local newspaper from one of our regional grocery/pharmacy chains that offered patients a savings on gas (