Care Manager Medication Management Curriculum Content

Medication System Organization:

• Open ended questions:
  • How do you know when to take which medications? What is your method or system to help you remember your meds?
  • Can you show me your medications for today? Can you show me all your medication bottles?
  • Where do you store your medications?
  • Can you show me or tell me your current medication list? What is each medication for?
  • How do you get to the pharmacy to pick up your medications?
  • Do you ever have trouble paying for your medications or not picked them up because you don’t have a way to pay for them?
  • Are you satisfied with the method of obtaining your meds, this include how they are packaged and how the package is opened?
  • If you have any problems with your medication such as side effects, frequency of doses, availability etc, how do you share that information with your primary care provider or pharmacist?
  • Questions specific for individuals with Diabetes:
    • When does you physician want you to call them related to blood glucose results?
    • Can you show me your blood glucose results?
    • What frequency do you check your blood glucose?
    • Do you have enough testing and medication administration supplies?
  • Other things to note:
    • Are there other indicators that might interfere with clients ability to organize their meds (mental health, manic, confusion, dementia, obstacles to compliance)
  • Tips for assessing via phone or video visit:
    • Identify specific questions to address this type of visit.
    • Review refills schedule
  • Options for medications systems:
    • Co-mingled blister packs with all pills for specific time of day, vs blister pack with individual pill cards.
    • Skilled service Med pour by visiting nurse
    • Dispensing systems (keep in mind need to accurately fill system and trouble shoot should system errors occur. May take family back up support or Skilled RN visit
    • Insurance coverage options within programs: MCO coverage of med pours, pharmacy comingled med packs and dispensing systems.
    • Pharmacy available services: which local pharmacy do med packs (ie cornerstone in Clinton area), amazon and other mail order options.

Red Flags that indicate potential issues around medication management:

• Extra medications that should have been used up already
• Running out of medications before refill time
• No system for organizing daily medication schedule (ie no medication box, meds in different locations throughout the house, meds cannot be found)
• Expired medications still in the house
• Medications on med list but not available in the home

Support client to advocate for themselves with their Primary Care Physician (PCP) and/or pharmacist

• Encourage asking what each medication is for
• Encourage questions about the medication side effects, especially if they are causing the client to not want to take the medication
• Encourage asking if there is a simpler medication or schedule that can be figured out especially if meds are taken at multiple times through out the day. IE is there a way to consolidate the number of or frequency of medications to make remembering easier?
• Encourage client to let PCP and or pharmacist know if they cannot afford or access the medications due to lack of funds or transportation issues
• Encourage use of local pharmacist to complete med reconciliation on discharge from hospital.

Additional material:

• Create FAQ with key points
• Decision Tree to support CM in taking action
• Encourage managers to incorporate key information into their workflow via documentation/EHR system design, or other method to assure long term sustainability
• Assessment sheet to include telehealth option