MTM Partner Site Interview Guide for Pharmacists

Form Approved

OMB No. 0920-xxxx

Exp. Date XX/XX/20XX

4i. MTM Partner-Site Level Interview Guide – (Strategy B4)

Note: Public reporting burden of this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-20HP)

Pharmacy Managers/Pharmacists

Date of Interview:
Interviewer:
Organization Name
Organization Type
State
Organization City		Zip Code
Strategies Implemented (select all that apply):	☐ B3 ☐ B4
Interviewee Name:		Position/Title

Introduction

Thank you for taking the time to participate in this interview. My name is [Insert name] and I am with the Deloitte evaluation team. Our team is working with the CDC Division for Heart Disease and Stroke Prevention. We understand your organization has been receiving support from the [insert state] Health Department to promote, expand, or enhance the practice of medication therapy management (MTM) for the management of cardiovascular disease. This support is provided to you under a CDC-funded project. CDC has hired Deloitte Consulting to evaluate this project to better understand how health departments are supporting MTM efforts within health care organizations and pharmacies.

The information collected from this interview will be analyzed together with information gained from interviews with others within your organization as well as from other healthcare organizations. We also will be conducting interviews with the state health department. Together, these interviews will provide valuable insights on different approaches for promoting the practice of MTM and which approaches seem to work well in specific contexts.

The interview is expected to take no longer than 1 hour. Your participation in this interview is completely voluntary. You may choose to skip questions or stop the interview at any time and it will not in any way impact the funding or technical assistance you receive from the health department or CDC. All information will be kept secure and any personally-identifiable information will be removed when results are aggregated for analysis.

If at any time during the interview you are not clear about what we’re asking, be sure to let me know. We appreciate your candid response.

With your permission, we would like to record this interview for transcription purposes.

Do we have your permission to record?

☐ Yes

☐ No

Do you have any questions or concerns before we start the interview?

1. Background

I’d like to start with some questions to understand the work [name of organization] is doing to support clients that have high blood pressure and high blood cholesterol, and also to understand your role within the organization.

1. Can you tell me about your pharmacy and the populations that it serves, specifically for cardiovascular related diseases?

Probe:

• What types of services/programs does your pharmacy offer to support individuals who have or at high risk for high blood pressure or high blood cholesterol?

• What are the overall goals of these programs? What is your pharmacy hoping to achieve through these programs?

• Can you describe to me the different populations (i.e. race, ethnicity, socioeconomic status, age, genders, etc.) that your pharmacy serves, specifically for services related to the prevention or management of high blood pressure or high blood cholesterol?

2. Can you tell me about your role in relation to supporting the practice of MTM?

Probe:

• How long have you been in this role?

• How long have you been working with this pharmacy?

2. MTM Practices

The following questions are going to ask you about how the health department is working with your pharmacy to promote, expand, or enhance MTM between pharmacists and physicians.

3. Does your pharmacy have a formal policy or guidance for implementing Medication Therapy Management for managing HBP/HBC?

Probe:

• What does this policy/guidance entail?

4. How does your pharmacy engage with healthcare providers to support MTM?

Probe:

• Can you tell me the types of healthcare organizations that you are working with (e.g. hospitals, independent practices, large health systems, rural health clinics, etc.)?

• What infrastructure is in place within your pharmacy to facilitate the practice of MTM?

• Does your pharmacy use a collaborative practice agreement?¹

IF YES –

• What do these agreements typically cover?

• Who is this agreement with?

• How many health care organizations do you have agreements with?

• Have you had different experiences in establishing MTM collaborative agreements across different types of health care organizations? Where have you seen more success/uptake?

IF NO -- what other mechanisms does your pharmacy use to establish a working relationship with a health care organization for MTM?

5. How do patients get referred to you for MTM?

Probe:

• Does your pharmacy have access to your partnering health care organizations’ health information systems/ EHRs?

• Once patients are referred to you, is there a system that allows you to enter and share data back to the patients’ primary provider on medication adherence or any changes in medication plan?

• Are there different MTM processes for managing patients with high blood pressure vs managing patients with cholesterol? Please describe the differences.

• Are there any tailored approaches that your pharmacy uses to provide MTM for priority populations?

6. What are some contextual factors that affect roll out of MTM between pharmacists and physicians?

3. Health Department Support

7. In what ways has the health department helped your pharmacy engage with health care organizations for MTM?

Probe:

• What do you think should be their role in this process?

• What types of health department interventions or activities were most helpful to your pharmacy to support MTM?

• How is the health department helping you with respect to developing workflows/systems to facilitate the delivery of MTM?

8. What are some of the challenges that you face with regards to working with physicians or other clinicians to support MTM?

Probe: How can the health department best help address these challenges?

9. What are some of the facilitators (i.e. resources, infrastructure, capacity, etc.) for engaging with physicians in the delivery of MTM?

Probe: How can the health department best encourage/support these facilitators?

4. Complementary Programs

Now I’d like to ask about other state-level or wide-reaching initiatives related to promoting or supporting MTM practices.

10. Do you have other partners, or additional funding sources outside of the HD for supporting engagement with health care organizations for MTM?

Probe:

• Could you tell me about other wide-reaching initiatives within your state that support the promotion, enhancement, or expansion of MTM between pharmacists and physicians?

• Is there any other support you need to further strengthen MTM practice within your pharmacy or expanding collaboration with health care organizations?

V. Effectiveness and Impact

I’d like to hear your opinion about how this work is contributing to client management.

11. In your opinion, how does the implementation of MTM support lifestyle modifications for patients?

12. To the best of your knowledge, how does MTM contribute to patient level health outcomes?

Probe:

• How does MTM support patients to control their blood pressure or blood cholesterol levels?

• How does MTM support patients to adhere to their medication plan?

13. To your knowledge, have there been any unintended or unexpected outcomes from the implementation of MTM? Please describe.

Wrap up

Those were all the questions I had for you. Is there anything else you’d like to add that we haven’t had a chance to discuss?

Close

Thank you so much for your time. This concludes our interview. If you have any additional questions, please feel free to contact Gizelle Gopez, ggopez@deloitte.com.

1 A formal agreement in which a licenses provider makes a diagnosis, supervises patient care, and refers patients to a pharmacist under a protocol that allows the pharmacist to perform specific patient care functions. – CDC’s Collaborative Practice Agreements and Pharmacists’ Patient Care Services. Retrieved: https://www.cdc.gov/dhdsp/pubs/docs/translational_tools_pharmacists.pdf

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