Medication Review Services Overview

Medication Review Service Overview

• A medication review is a patient-care service provided by a pharmacist.
• Pharmacists work to enhance the patient's understanding of their medication regimen.
• They identify and resolve drug therapy problems.
• They help improve health outcomes.

BC PharmaCare Medication Review Service

• This service is funded by PharmaCare.
• There are 3 types of medication review services provided at community pharmacies.
• Pharmacists can claim reimbursement for services provided.

Types of Medication Reviews

• Medication Review - Standard (MR-S): This review focuses on documenting present medications and their interactions.
• Medication Review - Pharmacist Consultation (MR-PC): This review occurs if a drug therapy problem is identified, resolved, and documented.
• Medication Review - Follow-Up (MR-F): This review occurs if a medication change or a drug therapy problem needs further assessment.

Patient Eligibility Criteria

• To be eligible for a medication review, patients must be BC residents.
• They must possess a BC Personal Health Number (PHN).
• The patient must have a minimum of 5 qualifying medications entered in PharmaNet within the past 6 months.
• They must have a clinical need for the service.
• Patients are not eligible if they are covered under PharmaCare Plan B.
• Patients must sign an acknowledgement on the Best Possible Medication History (BPMH) form.

Qualifying Medications

• Qualifying medications include prescriptions, compounded medications, and insulin.
• Non-qualifying medications include non-prescription items, vitamins, supplements, homeopathic products, vaccines, and discontinued prescriptions.

Clinical Need for Medication Review

• A prescriber may request a medication review.
• The patient may have multiple diseases, especially chronic illnesses.
• The patient may be taking non-prescription medications or natural health products (NHPs).
• The patient may have a drug therapy problem, a recent hospital discharge, multiple prescribers, or medications requiring laboratory monitoring.

Drug Therapy Problems (DTPs)

• DTPs are identified during medication reviews and can be categorized as:
  • Unnecessary drug
  • Needs additional drug
  • Ineffective drug
  • Dosage too low
  • Dosage too high
  • Adverse drug reaction
  • Patient self-management (non-adherence)

Resolving Drug Therapy Problems

• Pharmacists can resolve DTPs through actions like:
  • Adapting prescriptions
  • Giving immunizations
  • Contacting prescribers for changes to medication regimens
  • Changing or stopping non-prescription medications
  • Eliminating barriers for the patient
  • Providing education
  • Initiating monitoring
  • Referring to medical physicians or other health professionals
  • Making other recommendations

Allowable Number of Services

• Patients are eligible for one MR-S or MR-PC every 6 months.
• They are eligible for up to four MR-F every 12 months.
• To receive an MR-F service, patients must have already received an MR-S, MR-PC, or MR-PCN within the last year.

Documenting Medication Review Services

• Medication review documentation provides proof that the service was provided and ensures accurate information for patients, caregivers, and other healthcare professionals.
• BC PharmaCare provides template forms for documentation.
• Pharmacies must retain documentation to support claims.

Forms Used in Medication Review

• Best Possible Medication History (BPMH): This form has both a patient and health care professional section.
• Drug Therapy Problem (DTP) form: This form is used when a pharmacist identifies and/or resolves a DTP.
• Best Possible Medication History Worksheet: This form is optional.

BPMH Forms

• Patient Section: This section contains a list of all medications the patient is currently taking and is given to the patient after the service.
• Health Care Professionals Section: This section includes a summary of information for other healthcare professionals and acts as a record of care provided.

Requesting Medication Review Information

• Other healthcare providers can request medication review information by faxing a copy of the BPMH.

Claiming Medication Review Service Fees

• Claims must be submitted on PharmaNet on the date of the medication review service.
• Pharmacists enter their 10-digit pharmacy phone number in the Sig field and their College Reg ID number in the Prescriber ID field.
• Payment rates for each service include:
  • $60 for MR-S
  • $70 for MR-PC
  • $15 for MR-F

Medication Review Service

• Pharmacists provide medication review services to enhance patient understanding of their medication regimen, identify and resolve drug therapy problems, and improve health outcomes.

Eligibility Criteria

• Patients must be BC residents with a BC Personal Health Number (PHN).
• They cannot be covered under PharmaCare Plan B.
• They must have at least 5 qualifying medications entered in PharmaNet within the past 6 months.
• They must have a clinical need for the service and have not exceeded the allowable number of medication reviews.

Qualifying Medications

• Qualifying medications include prescription medications, compounded prescription medications (with a discrete PIN), and insulin.
• Qualifying medications do NOT include non-prescription products, over-the-counter medications, nutritional supplements, natural/homeopathic products, non-prescription compounds, vaccines, prescriptions with a “Discontinued,” “Reversed”, or “Not Filled” status on PharmaNet, or non-drug supplies (e.g., glucose testing supplies, insulin pump supplies, medical equipment & supplies).

Clinical Need for Medication Review

• Prescribers may request a medication review.
• Patients may have multiple diseases or chronic conditions.
• Patients may be taking non-prescription medications or natural health products.
• Patients may have a drug therapy problem.
• Patients may have been recently discharged from the hospital.
• Patients may have multiple prescribers.
• Patients may be receiving medications that require laboratory monitoring.

Types of Medication Review Services

• Medication Review-Standard (MR-S): A comprehensive review of the patient's medication regimen.
• Medication Review-Pharmacist Consultation (MR-PC): A review that has identified and resolved a drug therapy problem.
• Medication Review-Follow-Up (MR-F): A follow-up review after a medication change or to evaluate progress with a drug therapy problem.
• Medication Review-Primary Care Network (MR-PCN): A medication review provided by pharmacists in a primary care network (not eligible for PharmaCare payment).

Drug Therapy Problems (DTPs)

• Categories:
  • Unnecessary drug
  • Needs additional drug
  • Ineffective drug
  • Dosage too low
  • Dosage too high
  • Adverse drug reaction
  • Patient self-management (non-adherence)
• Actions by Pharmacist to Resolve DTP:
  • Adapt prescription
  • Give immunization
  • Contact prescriber to change/start/stop RX
  • Change/start/stop non-RX
  • Eliminate patient barrier
  • Provide education
  • Initiate monitoring
  • Refer to medical physician
  • Refer to other health professional
  • Other recommendation (specify)

Patient Eligibility for MR-F

• Patients must meet the same eligibility criteria as MR-S and MR-PC.
• They must have already received an MR-S, MR-PC, or MR-PCN within the past year.

Allowable Number of Medication Reviews

• Patients are eligible for one MR-S or MR-PC every six months (but not both).
• Patients can receive up to four MR-F every 12 months.

Claiming Medication Review Service Fees

• Claims must be submitted on PharmaNet on the date of service.
• Fees:
  • MR-S: $60
  • MR-PC: $70
  • MR-F: $15
• Pharmacist's 10-digit phone number must be entered in the "Sig" field on PharmaNet.
• Pharmacist's College registration ID number must be entered in the "Prescriber ID" field on PharmaNet.

Explore the essential aspects of medication review services provided by pharmacists. This quiz covers various types of medication reviews funded by BC PharmaCare, including Standard, Pharmacist Consultation, and Follow-Up reviews. Enhance your knowledge of how pharmacists improve patient outcomes through effective medication management.