Patient perceptions of their experience with comprehensive medication reviews: A framework for continued quality improvement

BACKGROUND: A comprehensive medication review (CMR) is an annual service offered to eligible Medicare Part D beneficiaries as a component of the Medication Therapy Management program. However, little is known about the most meaningful aspect of CMRs from the patient's perspective. This information is necessary to help improve the service. OBJECTIVE: To conduct concept elicitation interviews with patients who recently received a CMR to guide quality improvement efforts. METHODS: Those who recently received a telephonic CMR were invited to participate in semistructured interviews to provide their insights on the CMR service. An interview guide was used and contained the following 6 key questions (with additional probing questions) exploring: (1) overall experience, (2) medication knowledge, (3) concerns, (4) management, (5) satisfaction, and (6) experience. Interviews were transcribed and analyzed thematically. RESULTS: Interviews were conducted with 42 patients and resulted in the identification of themes related to the CMR service that were most meaningful to patients. The resulting framework contained 3 themes related to the content of the CMR (eg, medication review), the characteristics of the pharmacy professional (eg, professionalism), and the interaction during the CMR (eg, the telephonic experience). Intrinsic patient factors (eg, prior experiences) were also identified as important to contextualize patients' experiences. CONCLUSIONS: The framework provides concrete examples of the need for continued quality improvement of the CMR service and can be illustrated using the structure-process-outcome model. Patient perspectives should be accounted for in future quality improvement activities.