Carla Cobb, PharmD, BCPP, Clinical Pharmacist Practitioner, RiverStone Health, Billings, Montana, CPNP Government Affairs Council Chair
CPNP continues to advocate for pharmacists’ value in improving patient outcomes and reducing overall healthcare costs. As pharmacists we understand the value that we add to the patient’s team of providers. However, many other healthcare providers, payers, and legislators require education about the unique value that we bring to patient care.
One of the fundamentals of a professional practice is having a common language to be able to explain what we do. Even though some of these concepts have been around for years, I often hear or read conflicting definitions or interpretations of the terms. The following glossary will allow us to uniformly describe our patient care practice. In addition to speaking the same language, we all need to work toward practicing in a consistent manner in order for others to understand what we do. Once we do this, patients will start to expect the same type care from any patient care pharmacist that they encounter in the course of treatment by an integrated team of healthcare providers.
- Pharmaceutical care is the professional patient care practice provided by pharmacists, including the philosophy of responsibility and accountability to the patient. (Cipolle RJ, Strand L, Morley P. Pharmaceutical care practice: the patient-centered approach to medication management. 2012 3rd Edition. New York: McGraw-Hill)
- A patient care practice consists of a philosophy (pharmaceutical care), a process of care, and a system for providing patient care.
- A patient care process, as previously defined by other healthcare professionals, is the process that includes an assessment, development of a care plan, and a follow-up evaluation.
- Comprehensive medication management (CMM) is the patient care process provided by a pharmacist. It has been clearly defined and put into guidelines by the Patient-Centered Primary Care Collaborative (PCPCC), recognized by numerous organizations outside of pharmacy including physicians, employers, and payers. CPNP has accepted it as the patient care gold standard. The guidelines are available here.
- Collaborative drug therapy management, defined by individual state laws, allows a pharmacist to practice in collaboration with a physician to assist in managing medications to help patients reach treatment goals.
- Team-based care has been defined as “the provision of health services to individuals, families, and/or their communities by at least two health providers who work collaboratively with patients and their caregivers – to the extent preferred by each patient – to accomplish shared goals within and across settings to achieve coordinated, high-quality care.”
- Medication Therapy Management (MTM) is the term used by Medicare to describe the services that must be provided by Part D prescription drug plans. It is often used to describe a broad range of services provided by a pharmacist, including comprehensive medication reviews (http://www.pharmacist.com/mtm). It can lead to confusion when the term is used inconsistently from pharmacist to pharmacist.
- In May 2014 The Joint Commission of Pharmacy Practitioners (JCPP) released the “Pharmacists’ Patient Care Process”. It is a pharmacy document based on the philosophy of pharmaceutical care and is a brief summary of a patient care process developed from several key source documents including the PCPCC comprehensive medication management guidelines. It is available here.
A clear understanding and use of this terminology is an important foundation for making the case for including pharmacist as part of team-based care.