Journal of the American Pharmacists Association
Science and PracticeCommentaryA medication therapy management residency rotation adjusts to coronavirus disease 2019 constraints
Section snippets
Adjusting the rotation in response to COVID-19
By mid-March 2020, it was clear that in-person patient care aspects of the MTM rotation needed to be adjusted to mitigate the unnecessary risks of spreading coronavirus disease 2019 (COVID-19) to the community. Protecting the patients’ safety became a priority as most are in COVID-19 high-risk groups.2 Safety of the residents, preceptors, learners, and other pharmacy staff was also considered. Yet, residents were still expected to achieve the residency goals through quality patient care
In-person home visits shift to telephonic CMRs
HBMM visits are the backbone of the MTM rotation, with each resident performing two to three home visits each month. Because referrals come from within the health system, extensive information about the patient is available in the medical record. Once a referral for a home visit is received, a pharmacy technician calls the patient to schedule a date and time for the appointment. Residents are responsible for independently leading MTM encounters of all types, with preceptor assistance available
In-person Pillbox Teaching Clinic shifts to pillbox delivery
Residents also staff the Pillbox Teaching Clinic for four hours every month. In this clinic, pharmacists work one-on-one with patients to improve medication adherence and develop longitudinal relationships. Each resident class is expected to see 20 patients for at least three encounters throughout the year.
During the clinic visit, the pharmacist reviews the returned pillboxes to assess adherence and discusses reasons for any missed doses with the patient. If the patient sees providers within
Learnings and takeaways
The residents who experienced the transition to the outlined modifications in March 2020 for this rotation quickly adapted. The change from home visits to telephonic MTM was not a difficult transition for them because they had already built strong patient interviewing and counseling skills over the preceding nine months and were able to use those skills in the telephonic environment. Likewise, adjusting to the new pillbox clinic format went well because they had already formed strong
Moving forward
As the COVID-19 pandemic continues for the foreseeable future, it is likely these rotation modifications will stay in place until the end of the 2020-2021 residency year. Although the COVID-19 modifications have continued to provide a meaningful clinical experience, the community residents will return to in-person home visits and pillbox clinic once it is safe to do so. There are several action items the residency program is taking on as a result of the pandemic which other residency programs
Conclusion
Despite several challenges posed to the MTM rotation because of the COVID-19 pandemic, adjustments were quickly made to ensure residents are still able to provide meaningful clinical care, patients are still receiving services, and everyone involved is protected. The shift from home visits to telephonic CMRs has continued to provide meaningful clinical experiences for the residents. Adjusting in-person pillbox clinic to a pillbox delivery service poses logistical challenges for the residents
Danielle Pennock, PharmD, Postgraduate Year 2 Community-based Pharmacy Administration and Leadership Resident, Department of Pharmacy Services, Johns Hopkins Home Care Group, Baltimore, MD
References (2)
- et al.
Medication management through pharmacist-provided home-based services
J Am Coll Clin Pharm
(2020) People with certain medical conditions. Coronavirus Disease 2019 (COVID-19)
Cited by (2)
Pharmacy residents have grit!
2021, Journal of the American Pharmacists Association
Danielle Pennock, PharmD, Postgraduate Year 2 Community-based Pharmacy Administration and Leadership Resident, Department of Pharmacy Services, Johns Hopkins Home Care Group, Baltimore, MD
Lauren Barbour, PharmD, MPH, Clinical Coordinator, Department of Pharmacy Services, Johns Hopkins Home Care Group, Baltimore, MD
Robert Green, PharmD, BCGP, Clinical Coordinator, Department of Pharmacy Services, Johns Hopkins Home Care Group, Baltimore, MD
Denise Fu, PharmD, BCACP, Clinical Programs Manager, Patient Care Services, Department of Pharmacy Services, Johns Hopkins Home Care Group, Baltimore, MD
Disclosure: The authors declare no relevant conflicts of interest or financial relationships.