Abstract

Background

Community pharmacists provide comprehensive medication reviews (CMRs) through pharmacy contracts with medication therapy management (MTM) vendors. These CMRs are documented in the vendors' web-based MTM software platforms, which often integrate alerts to assist pharmacists in the detection of medication therapy problems. Understanding pharmacists’ experiences with MTM alerts is critical to optimizing alert design for patient care.

Objectives

The objectives of this study were to 1) assess the usability and usefulness of MTM alerts for MTM vendor-contracted community pharmacists and 2) generate recommendations for improving MTM alerts for use by community pharmacists.

Methods

This was a convergent, parallel mixed-methods evaluation of data collected from 3 sources, with individual pharmacists contributing data to one or more sources: 1) community pharmacists' submissions of observational data about MTM alerts encountered during routine MTM provision, 2) videos of naturalistic usability testing of MTM alerts, and 3) semi-structured interviews to elicit pharmacists' perspectives on MTM alert usefulness and usability. MTM alert data submitted by pharmacists were summarized with descriptive statistics. Usability testing videos were analyzed to determine pharmacists’ time spent on MTM alerts and to identify negative usability incidents. Interview transcripts were analyzed using a hybrid approach of deductive and inductive codes to identify emergent themes. Triangulation of data (i.e., determination of convergence/divergence in findings across all data sources) occurred through investigator discussion and identified overarching findings pertaining to key MTM alert challenges. These resulted in actionable recommendations to improve MTM alerts for use by community pharmacists.

Results

Collectively, two and four overarching key challenges pertaining to MTM alert usability and usefulness, respectively, were identified, resulting in 15 actionable recommendations for improving the design of MTM alerts from a user-centered perspective.

Conclusions

Recommendations are expected to inform enhanced MTM alert designs that can improve pharmacist efficiency, patient and prescriber satisfaction with MTM, and patient outcomes.

Comments

This is the author-accepted manuscript of:

Margie E. Snyder, Omolola A. Adeoye-Olatunde, Stephanie A. Gernant, Julie DiIulio, Heather A. Jaynes, William R. Doucette, Alissa L. Russ-Jara, A user-centered evaluation of medication therapy management alerts for community pharmacists: Recommendations to improve usability and usefulness, Research in Social and Administrative Pharmacy, Volume 17, Issue 8, 2021, Pages 1433-1443.

Copyright Elsevier, it is made available here CC-BY-NC-ND, and the version of record is available at DOI: 10.1016/j.sapharm.2020.10.015.

Keywords

Community pharmacy services; medication therapy management; Medicare; decision support systems, clinical

Date of this Version

2021

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