Establishing a common language for the comprehensive medication management patient care process: Applying implementation science to standardize care delivery

Background: Pharmacists' interventions, particularly in the primary care setting, have demonstrated positive outcomes on patient care, but rarely translate into impact and scale when reviewed systematically. Specifically, comprehensive medication management (CMM) is often poorly understood, not well defined, and lacks a measure of fidelity. A consistent approach to delivery of CMM is critical to ensure impact. One way to achieve this is to establish the usability of an intervention, so practitioners have a common language around implementation of CMM to ensure fidelity and facilitate positive outcomes on patient care. Objective(s): The goal of this study was to establish a common language for the CMM patient care process. Methods: This study applies an established implementation science methodology and the Usable Innovation Framework to define and operationalize CMM through a network of 40 diverse primary care practices across the United States. This approach to the development of a CMM patient care process common language document included three phases: (a) Review and synthesis of the literature, (b) Vetting and consensus building, and (c) Usability testing. Results: The end product is the CMM patient care process—a common language document that describes both the five essential functions (ie, core components that must be present to carry out CMM) as well as operational definitions (ie, specific steps, activities, or tasks that must be carried out to achieve each essential function). Conclusions: Establishing a common language for the CMM patient care process ensures consistency in delivery of CMM and establishes a set of expectations across key stakeholder groups including patients, pharmacists, physicians, other health care providers, and payers. This research provides a framework and a common set of essential functions and operational definitions to guide the implementation of CMM delivery in primary care and facilitate replication, scale, and positive impact.