How to conduct
MedsCheck
For patients with Cardiovascular Disease
2013
“Tell me and I forget. Teach me and I remember. Involve me and I learn.” Benjamin Franklin Welcome to the Guild Pharmacy Academy MedsCheck Workshop. This interactive workshop has been specifically designed to provide you with information on the rules regarding MedsCheck but more importantly how you can conduct MedsCheck in your pharmacy The interactive training course involving discussions and workshops will be facilitated by Meryl Kane Assessment will be carried out at the end of the session by completing a MedsCheck Worksheet. Agenda Welcome, Introduction and aims of MedsCheck, Aim of the Workshop Is your pharmacy eligible? Starting MedsCheck Promoting MedsCheck Strategies for providing the MedsCheck service Adherence, barriers for adherence Consider disease States Communication, Claiming Documentation MedsCheck Exercise We trust you get the most out of your Guild Pharmacy Academy training session. We also have included an Evaluation Form to enable you to let us know what you thought of the session. We value your opinions and encourage you to share them with us. Please feel free to contact us any time on (02) 9467‐7132 or at: [email protected]. All the best Carlene Smith
Carlene Smith Guild Clinical Co‐ordinator Training 11/2/2013
MedsCheck
M d Ch k
MedsCheck
Community Pharmacy Service for consumers who Community Pharmacy Service for consumers who live in the community:
live in the community:

 Cardiovascular Disease
Cardiovascular Disease
MedsCheck Aim

Identify problems that the consumer may be experiencing with their medicines

Help the consumer learn more about their medicines including how medicines affect medical conditions 
Effective use of medicines by consumers

Educate consumers about how to best use and store their medicines Investigate problems
Provide education and support
pp
Ensure effective use of medicines
Pharmacy Eligibility
 Section 90 pharmacy
 Be a Registered Pharmacist or have access to the services of a Registered Pharmacist through employment or service contract relationships
p y
p
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DSM vs MedsCheck vs HMR
DSM
MedsCheck
HMR
Medicines & condition counselling in targeted disease
Medicine review, may include interactions
Clinical review
Patient concerns; disease management
Medicine review focussing on compliance & education
Comprehensive medicine
review ;all meds and management issues
Usually opportunistic, e.g. on script collection; can be g g
ongoing
In pharmacy, usually on appt; usually service at most yearly
Ideally in home, with appt; usually service at most yearly
No referral needed
No referral needed
GP referral needed
Advice and support to help patient self management
Tailored med advice, identify med issues and report (action plan & meds list)
Provides GP with report on pt’s med management (med issues, strategies to resolve); Mgmt
plan disc w pt & copied to phcy
A service under PHC‐PPI; incentive
$60 or $90 (diabetes) fee/service
$200.92 per HMR
MedsCheck Service Requirements
 Whilst conducting MedsChecks the pharmacist should not be responsible for other professional duties
 Suggest at least TWO registered pharmacists on duty  Must be conducted in a screened area or separate room distinct from the general public area of the pharmacy.
 Ideally, computer, printer and internet Id ll
t
i t
di t
t
access in the screened or consulting area.
 Access to support resources on health
information, medications and monitoring devices.
www.5cpa.com.au/medscheck 
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MedsCheck Consumers Eligibility Criteria  Be a Medicare and/or DVA cardholder;  Have not received a MedsCheck, Diabetes MedsCheck, HMR or RMMR in the last 12 months;  Be living at home in a community setting;  Be taking five or more prescription medicines
or
the consumer has had a recent significant medical event 
Recent significant medical event in a MedsCheck
A significant medical event can be defined as a recent event or new diagnosis that has the potential to impact on the consumer’s medication adherence or knowledge of their medicine regime and may increase the risk of medication misadventure.
www.5cpa.com.au/medscheck 
Promoting your MedsCheck services
Once you have received written approval to provide the service….
 You can organise promotion using the brochures and posters which are freely available from the Guild
o Download at www.5cpa.com.au/medscheck or order copies from the 5CPA Help Line 1300 555 262
 Consider the local paper and some editorial space
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Strategies for your MedsCheck Services
Once your pharmacy has received written approval DHS (Medicare) to provide the MedsCheck services…….
 Appointment ‐ have diary in the pharmacy
 Train
Train staff
staff‐ Assistants and Interns can discuss the service with Assistants and Interns can discuss the service with
consumers about and make appointments on a specific day
 Pre‐prepare list of medicines from pharmacy history
 Privacy‐ ensure interruption free, private time
Service Checklist
 Outlines the requirements in each stage of the MedsCheck process
 Available from www.5cpa.com.au
MedsCheck is …..
About Adherence, Education and Self Management
To find out about adherence you need to consider
 What are the factors that reduce adherence?
 What makes people change what they are doing with their medicines? ………………………………………………………..Communication
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Adherence can be poor because….
 Lack of knowledge about disease state or medicines
 Lack of understanding about why they are taking their medicines
 Lack of belief that the medicines are working
 Confusion regarding the use of the medicines
 Lack of a routine to take their medicines
What would you  Poor vision
ask to find out about these  Poor hearing
topics?
 Poor dexterity
Communication can be crucial!
Asking questions to find out how the consumer feels about their medicines can be affected by the way we ask the question as well as what we ask!
Motivational
Show consideration and empathy
Non judgmental
Aim for better use of medicines
Consider the particular disease states
While there are some basic questions you will need to ask some disease states will cause you to ask extra questions
– Consider Cardiovascular Disease
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Cardiovascular Disease ‐ Hypertension
 Start with the basic.. what, when how, why?
 Consider memory issues
 Do you sometimes forget to take your medicines? What do you do?
 How do you know BP is controlled?
 Do you know what your BP is?
 Do you monitor BP? How often?
 Do you ever feel dizzy or light headed?
Cardiovascular Disease ‐ IHD
 Start with the basic, what, when how, why?
 Consider memory issues
 Do you sometimes forget to take your medicines?
 Do you ever forget to remove the patch?
 How do you know Angina is controlled?
 Do you have any chest pain?
 Do you have Anginine tablets or a GTN Spray?
o How often do you use it?
Cardiovascular Disease ‐ Heart Failure
 Start with the basic, what, when how, why?
 Consider memory issues
 Do you sometimes forget to take your medicines?
 What do you do then?
 How do you know Heart Failure is controlled?
 Do you ever have any chest pain?
 Do you have a salt reduced diet?  Do you have any fluid restrictions?
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If the consumer has Heart Failure
Consider the standard treatment for heart failure
 Ace Inhibitors

BetaBlockers

Frusemide

Weight control
Weight control

Fluid restriction
If you did a MedsCheck and found that the treatment was not
according to standards, then you would recommend an HMR
Therapeutic Guidelines Cardiovascular and http://www.heartfoundation.org.au/your‐heart/cardiovascular‐conditions/Pages/default.aspx
Other thoughts......
 Consider diet (low salt) and exercise
 Consider other drugs that can worsen condition
 Consider some common adverse effects

Calcium Channel Blockers: constipation, oedema

BetaBlockers: cold extremities, asthma

ACE Inhibitors, ARBs: cough

Diuretics: incontinence
Therapeutic Guidelines Cardiovascular and http://www.heartfoundation.org.au/your‐
heart/cardiovascular‐conditions/Pages/default.aspx
Documentation

Once you have all the information you can help the consumer improve their knowledge of the condition and the medicines

If you find information consistent with adverse effects……………… you can recommend an HMR

If you find non adherence is an issue ……………………………...you can recommend a DAA

Give the consumer their medication list and the report should be attached and file all consultation documentation for 7 years
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Documentation and claiming
 There are 2 forms for Claims:
 MedsCheck Program Claim cover sheet
 MedsCheck Program Payment Application
 MedsCheck fee $60 (GST exempt)
$
 Claims submitted to DHS (Medicare) by the 14th of the month routinely paid in the next month
 File all consultation documentation for 7 years
Claiming Resources to help you
www.5cpa.com.au






Program Specific Guidelines
Factsheets & FAQs
PSA Standards and Guidelines
MMR Terms and Conditions
QCPP checklist
myCPD online MedsCheck modules – www.mycpd.org.au
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Support and information
Visit: www.5cpa.com.au Email: [email protected] Phone:1300 555 262
TIP: make www.5cpa.com.au a favourite
MedsCheck Case
MedsCheck Workshop Worksheet
Mrs Tamara Blue is a long standing consumer and is
Name:……………………………………………………………………
taking
…….
Amlodipine 10 mg
Pharmacy:………………………………………………………………
1d Metoprolol 50mg
…….
Phone:……………………………………..
1 bd Atorvastatin
80mg n Rocaltrol 1 Email:
bd
…………………………………………………………………………….
Column
1 and 3 are500mg
issues that affect
medication taking, what questions would you ask to help identify if there are any issues to
Paracetamol
2 tds resolve? Consider
what the potential outcomes of the MedsCheck may be, in the last line
prn
Issues
Questions
Issues
Questions
Usefulness
Compliance
of meds
PRN meds Other meds
Adver
se effect
s
Self Self
Sufficien
cy
Storage
Out of date meds
Lifestyle
Beliefs
Knowledge
Any
clinical issues
Potential Outcome
s Of MedsChe
ck
Potential Outcome
s Of MedsChe
ck
The Pharmacy Guild of Australia NSW Branch
Thank you for your attendance, we hope you find MedsCheck a useful service to offer to your patients
your patients
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The Guild Pharmacy Academy
Professional training for community pharmacy including:
• All Pharmacists
• Interns
• Pharmacy Assistants
• Pharmacy Managers
Incorporating:
• Guild Training (Pharmacy Assistants)
• Guild Clinical Training (Pharmacists, Interns)
• Guild Intern Training (Interns)
• Guild Business Training (Pharmacists, Interns, Pharmacy Assistants, Pharmacy Managers)
My CPD
As part of national registration all pharmacists will need to keep records of their continuing
professional development (CPD) and you can record your CPD @ www.guildtraining.com.au
Any pharmacist may use this website to keep track of their CPD points, as required under
national registration. The site also includes a calendar of CPD eligible events for each State
and Territory.
Make a commitment to quality ...
For more information on Training Courses, please contact:
Guild Training
(Pharmacy Assistants)
Telephone:
(02) 9467 7130
Facsimile:
(02) 9467 7165
Email:
[email protected]
Guild Clinical Training
(Pharmacists, Interns)
Telephone:
(02) 9467 7132
Facsimile:
(02) 9467 7181
Email:
[email protected]
Guild Business Training
(Pharmacists, Interns, Pharmacy Assistants, Pharmacy Managers)
Telephone:
(02) 9467 7132
Facsimile:
(02) 9467 7181
Email:
[email protected]
Guild Intern Training
(Interns)
Telephone:
(02) 9467 7124
Facsimile:
(02) 9467 7125
Email:
[email protected]
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CPD by the SEA - NSW Convention
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(incorporating Zone Leaders Conference)
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Friday 22 - Sunday 24 February 2013
Novotel Manly Pacific
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Catch the early wave & secure your CPD Credits!
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www.cpdbythesea.com.au
NSW based events provide the opportunity to secure 50+ CPD credits.
Open to everyone in pharmacy, nationally!
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NSW Pharmacy - National Convention & Exhibition
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Friday 21 - Sunday 23 June 2013
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Sydney Convention & Exhibition Centre
Darling Harbour
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Learn to survive & THRIVE!
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