Role of the Pharmacy Team
Scroll through the workflow process step-by-step.
Identify possible participants
Review all patients who have obtained a prescription at your pharmacy in the last 12 months, by NDC number, to identify possible program participants.
Of those patients that have a qualifying NDC number, review their fill/refill information to see which patients are likely non-adherent.
Prepare your introductory speech to offer participation in the P-MAPP.
Offer to Participate / ARMS-12©
Of those patients that are likely non-adherent, present the offer to participate in the P-MAPP.
If the patient says “yes” they are interested in participation, hand them the tablet and ask them to take the ARMS-12© risk assessment.
The patient will complete the ARMS-12© risk assessment. If they qualify, the system will request that they continue. If they do not qualify (i.e. they are highly adherent), the system will thank them and nothing further will be required.
Patient Information & eSign Documents
If the patient qualifies based on the ARMS-12©, they will then be asked to:
(1) complete demographic information
(2) identify their prescribing physician
(3) digitally sign the Informed Consent Form
(4) digitally sign the Release of Health Information Form. The pharmacist will verify the patient demographic information and digitally co-sign the Informed Consent from the Pharmacy Dashboard.
(1) complete demographic information
(2) identify their prescribing physician
(3) digitally sign the Informed Consent Form
(4) digitally sign the Release of Health Information Form. The pharmacist will verify the patient demographic information and digitally co-sign the Informed Consent from the Pharmacy Dashboard.
Baseline PRO
Following these digital signatures, the patient will complete the Baseline Patient Reported Outcome Survey. This may require pharmacy staff assistance if the patient does not know the names of their diabetes medications.
Stratification & Randomization
Following completion of the Baseline Patient Reported Outcome Survey, the patient will be automatically stratified into 1 of 3 groups:
(1) oral agents only
(2) GLP-1 agonist +/- oral agents
(3) basal insulin +/- GLP-1 agonist +/- oral agents.
Within each stratum, the patient will be randomized in a 1:2 manner to either Routine Care (RC) or Routine Care + IMB profile. If the patient is randomized to Routine Care only, a member of the pharmacy staff will obtain the patient’s weight, blood pressure and finger stick lab tests in that order. Weight should be with shoes but without jackets, coats, sweaters, or sweatshirts. Blood pressure should be taken in the non-dominant arm. If the patient is randomized to Routine Care + IMB, in addition to weight, blood pressure and finger stick lab tests described above, they will need to complete the IMB profile. This can be done at the pharmacy, following the completion of the Baseline Patient Reported Outcome survey or at home using a personal computer or tablet. The baseline IMB profile must be completed within 5 days of the Baseline Patient Reported Outcome survey.
(1) oral agents only
(2) GLP-1 agonist +/- oral agents
(3) basal insulin +/- GLP-1 agonist +/- oral agents.
Within each stratum, the patient will be randomized in a 1:2 manner to either Routine Care (RC) or Routine Care + IMB profile. If the patient is randomized to Routine Care only, a member of the pharmacy staff will obtain the patient’s weight, blood pressure and finger stick lab tests in that order. Weight should be with shoes but without jackets, coats, sweaters, or sweatshirts. Blood pressure should be taken in the non-dominant arm. If the patient is randomized to Routine Care + IMB, in addition to weight, blood pressure and finger stick lab tests described above, they will need to complete the IMB profile. This can be done at the pharmacy, following the completion of the Baseline Patient Reported Outcome survey or at home using a personal computer or tablet. The baseline IMB profile must be completed within 5 days of the Baseline Patient Reported Outcome survey.
Motivational Interviewing
Following completion of the baseline IMB profile, the patient must schedule an appointment with the pharmacist. At this appointment, the pharmacist will review the IMB profile and utilize Motivational Interviewing to help improve adherence deficits. The pharmacist will record the action items suggested at this meeting in the patient's record on the Pharmacy Dashboard. Motivational Interviewing can only be conducted by pharmacists who have completed the necessary training.
Follow-Up PRO
Patients randomized to Routine Care only will complete follow-up Patient Reported Outcome surveys at months 1, 2, 3, 4, 6, 9 and 12 either at home on their computer, in the pharmacy or by telephone. These patients will have repeat weight, blood pressure and finger stick lab tests performed at months 3, 6, 9 and 12 in the pharmacy.
Patients randomized to Routine Care + IMB will complete follow-up Patient Reported Outcome surveys at months 1, 2, 3, 4, 6, 9 and 12 either at home on their computer, in the pharmacy or by telephone. These patients will have repeat weight, blood pressure and finger stick lab tests performed at months 3, 6, 9 and 12 in the pharmacy. In addition, these patients will have repeat IMB Profile and Motivational Interviewing at months 2, 4, 6 and 9.
Fill/Refill Information
Send copy of patients' fill/refill information for all medications to MediMergent electronically every 30 days.
Information should include: patients' id#, drug name, dose, frequency, route of administration, quantity dispensed, date picked up by patients.
Information should include: patients' id#, drug name, dose, frequency, route of administration, quantity dispensed, date picked up by patients.
Enrolled through pharmacies like yours, patients report on their experiences with a targeted category of medications via a survey of questions which collect information on side effects, medication adherence and health outcomes. Survey responses are sent to each patient’s healthcare provider. In addition, the data collected in patient surveys are de-identified, coded and stored in the P-MAPP database. This information is then integrated with other sources of patient information, including the patient’s health records, pharmacy fill/refill data and medical claims to create a de-identified, aggregated database of real-world clinical outcomes and patterns of behaviour related to medication (non-)adherence.