the apo-amts model medication review and clinical pharmacy
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I. Waltering, PharmD, Medicationtherapy safety
coordinator, geriatic pharmacist
Institute for Pharmaceutical and
Chemical Medicine
The Apo-AMTS Model
Medication review and Clinical Pharmacy in
community pharmacies
A new training for pre-registration students
I. Waltering, PharmD
Outline
•Development
•Aims
•Competency
•Systematics
•Implementation
•Evaluation
The Apo-AMTS-Model 2
I. Waltering, PharmD
Development
• The Apo-AMTS Concept was developed by the professors of Clinical
Pharmacy in Northrhine-Westphalia
• Prof. S. Läer – Heinrich Heine – University, Duesseldorf
• Prof. U. Jaehde – Rheinische Friedrich-Wilhelms-University, Bonn
• Prof. G. Hempel – Westphalian Wilhelms-University, Muenster
• In co-operation with the departmental heads of continous education of the
chambers of pharmacy
• Dr. H. Mueller, Muenster
• B. Seibt, Duesseldorf
The Apo-AMTS-Model 3
I. Waltering, PharmD
The Origin
The Apo-AMTS-Model 4
Apo -
AMTS
ArzneiMittel
Medication Therapie
Therapy
Sicherheit
Safety Quellen: coowio.de; taz.de; zfos.de;Telekom-handel.de
I. Waltering, PharmD
Target groups
• Pre-registration pharmacy students
• Pharmacists in community pharmacy
The Apo-AMTS-Model 5
I. Waltering, PharmD
Aims
• Sustained increase in competency and acceptance of pharmacists and
community pharmacies in Northrhine-Westphalia
• Improved quality of education of pre-registration students („PhiP“)
• Preparedness for future tasks in community pharmacy, especially in the
area of medication and patient safety („AMTS“)
• Inclusion of the „older generation“ of pharmacists
combination of clinical skills and communication skills and clinical
judgement
• Health services research important for establishing payed services in the
future
The Apo-AMTS-Model 6
I. Waltering, PharmD
Why now?
• It is time for a change!
• Political interest
The Apo-AMTS-Model 7
I. Waltering, PharmD
The basis
•Medication-therapy-safety concepts
are based on two columns
•Competency
•Systematics
The Apo-AMTS-Model 8
I. Waltering, PharmD
Competency
• Kowledge of medication therapy
• Drugs
• Diagnostics
• Therapeutic concepts and guidelines
• Adverse events and medication errors
• Communiction skills and strategies
• Competency in patient safety
The Apo-AMTS-Model 9
I. Waltering, PharmD
Systematics
• Specified and graduated approach of medication
reviews
• Systematic approach with a manual
• Documentation
• Reassurance through the patient
• Evaluation
• Improved quality
The Apo-AMTS-Model 10
I. Waltering, PharmD
Implementation
• Two levels
• AMTS – teaching Pharmacy
• AMTS – qualfied Pharmacy +
AMTS – Manager
The Apo-AMTS-Model 11
I. Waltering, PharmD
Implementation – Level 1
AMTS – teaching Pharmacy
• Accreditation requirements of the pharmacies
• The training pharmacist has a continuing education certificate
• The pharmacy is visited by pseudo-customers on a regular basis
• Compounding is tested by a central laboratory
• The pharmacy counducts blood-test
• Patient customer cards are used in the pharmacy
• Student and supervisor are having an expert discussion at least every
other week
• The student is payed by labor agreement
• The training follows a training schedule
The Apo-AMTS-Model 12
I. Waltering, PharmD
The Apo-AMTS-Model 13
I. Waltering, PharmD
Implementation– Level 1
• The training schedule
• Based on the demands of the ordinance of licensure for
Pharmacists
• Composed as a check-list
• Helps the student to follow his training-process
• Improves the self-control
• Identifies helpful literature
• Introduces the regulatory framework
• Complets the education through specific tasks
• Forces the trainer and trainee to communicate with each other
The Apo-AMTS-Model 14
I. Waltering, PharmD
The training schedule
The Apo-AMTS-Model 15
I. Waltering, PharmD
The training-schedule -Preparation-
The Apo-AMTS-Model 16
I. Waltering, PharmD
The training schedule
The Apo-AMTS-Model 17
I. Waltering, PharmD
Implementation – Level 1
Basic course (4h)
• Teaching pharmacist plus pre-registration student
• Content
• Drug therapy as a high-risk process
• Aspects of Patient safety (according to WHO Patient Safety
Curriculum)
• Identification of
• High risk patients
• High risk drugs
• High risk situations
The Apo-AMTS-Model 18
I. Waltering, PharmD
Implementation – Level 1 (cont.)
Basic course
• The medication process and medication-related problems within
this process
• Medication error, error-reporting systems (Reason, CIRS …)
• Identification of adverse events and management
• Management of drug-drug interactions
• Communication with patients and other health care professionals
• Team forming process
• PDCA - Cycle
• Different levels of medications reviews
The Apo-AMTS-Model 19
I. Waltering, PharmD
The Apo-AMTS Model
PhiP
AMTS – Basic course(4h)
ST
E P
1
AMTS – Teaching
Pharmacy
Accredited Pharmacy
Teaching Pharmacist
© AMTS-Basisschulung 2012 Hempel/Schwalbe/Waltering
I. Waltering, PharmD
The Apo-AMTS-Model 21
I. Waltering, PharmD
Implementation – Level 2
AMTS – Courses
• 3 classes with 8 hours
• Consolidation of the content of the basic course
• Presentations and small groups
• Case – based learning of conducting systematic medication reviews on an
intermediate level
• Applying therapeutic guidelines
• Managing side-effects and interactions for special indications
• CHF, HTN, CAD, Afib, RA, Dementia, Depression, Parkinson,
Asthma/COPD, DM, Pain, Oncology and Immuno-suppression
• Training of communication skills
• Finding solutions for problems in selected disease states and communicate
these with other health-care professionals
The Apo-AMTS-Model 22
I. Waltering, PharmD
The Apo-AMTS Model S
TE
P 2
AMTS -
MANAGER
Advanced training I 8h
Advanced training II 8h
Advanced training III 8h
Education in
pharmacy
with
teaching
schedule MM for 5 Patients,
Documentation
Attendance of AMTS-Symposium
AMTS – Qualified
Pharmacy
Evaluation and scientific supervision
June/ July
2013
7./8./9.
2013
Oct. 2013
Recertification after 3 years
145
© AMTS-Basisschulung 2012 Hempel/Schwalbe/Waltering
I. Waltering, PharmD
Evaluation
• Evaluation of each course with
questionnaires
•Free-text and suggestions for
improvement
• Visits of the students while they
work in community pharmacy
The Apo-AMTS-Model 24
I. Waltering, PharmD
The Apo-AMTS-Model 25
I. Waltering, PharmD
The Apo-AMTS-Model 26
Thank you for your attention!
I. Waltering, PharmD
The Apo-AMTS-Model 27
Any
Questions
?
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