(Step 5 In The Wpqc-certification Process)
You have completed the required action items in the WPQC homestudy and you are well on your way to becoming WPQC certified! Now, you need to answer the following questions to ensure you have a basic working knowledge of WPQC program requirements. Once you pass, you will receive a certificate announcing you have completed the homestudy assessment. (Once you have completed all of the training components, you will receive a formal certificate in the mail stating you are WPQC-certified!)
- 1.The CMS innovation grant is focused primarily on improving patient health outcomes in which four disease states?
- A.
Depression, geriatric syndromes, hypertension, and asthma
- B.
Asthma, geriatric syndromes, heart failure, and diabetes
- C.
Chronic heart failure, diabetes, hyperlipidemia, and asthma
- D.
Diabetes, depression, hypertension, and COPD
- E.
None of the above
- 2.To become a certified WPQC pharmacy, which quality measures are required to be in place?
- A.
Consistent verification and documentation of allergies and adverse drug reactions
- B.
Implementation of a continuous quality improvement (CQI) program for medication risk management
- C.
Use of a standard procedure to show every patient each medication
- D.
A & C
- E.
All of the above
- 3.All WPQC participating pharmacists are required to have a personal NPI number (National Provider Identifier).
- A.
True
- B.
False
- 4.All professional pharmacy staff, including pharmacy technicians, may participate in the identification of Level I interventions.
- A.
True
- B.
False
- 5.Only pharmacists are allowed to join Practice Interest Networks (PINs). There are no networks in which pharmacy technicians can join.
- A.
True
- B.
False
- 6.Mr. Jones stops into the pharmacy on a Monday afternoon with a new prescription for Nexium™ 20mg. Judy, the pharmacy technician, notes that he is eligible for a Level I service. Judy fills the prescription as is and puts a hot pink note card in the basket to flag the pharmacist. The pharmacist notes this is a possible ______________________ intervention.
- A.
Focused Adherence
- B.
Medication Addition
- C.
Medication Device Instruction
- D.
Cost Effectiveness
- 7.Mrs. Smith stops into the pharmacy for the second time this month to refill her albuterol inhaler. When reviewing her profile, the pharmacist notices Mrs. Smith’s past medical history includes asthma and hypertension. Her current medication list includes hydrochlorothiazide, omeprazole, her albuterol HFA, and a fluticasone/salmeterol inhaler that has not been refilled in over a month. “I don’t like that one,” Mrs. Smith admits. “It doesn’t work as well as my albuterol.” The pharmacist sees the opportunity for which WPQC services?
- A.
Medication Deletion (L1) and Cost Effectiveness (L1)
- B.
Comprehensive Medication Review/Assessment (L2), which includes Focused Adherence (L1) and Medication Device Instruction (L1)
- C.
Focused Adherence (L1), Mrs. Smith does not qualify for a CMR/A.
- D.
Three-Month Supply (L1), Mrs. Smith clearly finds it inconvenient to pick up her medications every month.
- 8.Which of these patients is not eligible for a Level II Comprehensive Medication Review/Assessment at this time?
- A.
A 45 year old gentleman with a history of hypertension, recently diagnosed with type II diabetes mellitus
- B.
A 19 year old young woman who had a kidney transplant one year ago and seems only to be able to identify her 7 medicines by color
- C.
A 57 year old woman currently taking citalopram daily and lorazepam prn for depression and anxiety
- D.
A 78 year old gentleman who was discharged from a local hospital yesterday due to a myocardial infarction
- 9.In preparation for a Level II CMR/A appointment, the pharmacy technician or pharmacist should ask the patient to bring in:
- A.
All medication devices (inhalers, blood glucose meters, etc.)
- B.
Allergy information
- C.
All medications including over-the-counter products and samples
- D.
Logbooks or health journals
- E.
All of the above
- 10.What information is important to gather before the patient arrives for a CMR/A?
- A.
Medications the patient has filled at your pharmacy
- B.
Lab values from the patient's health care provider
- C.
Adherence issues based on refill history
- D.
Possible drug therapy problems or interventions
- E.
All of the above
- 11.What information would be important to gather from the patient during the CMR/A interview?
- A.
Medication list/wallet card
- B.
Recent admissions to the hospital
- C.
Smoking history
- D.
Other pharmacies the patient uses
- E.
His/her goals for the CMR/A
- F.
All of the above
- 12.Which of the following would be appropriate questions to ask when interviewing a patient during a CMR/A?
- A.
Are you using your inhaler correctly?
- B.
How are you taking your cholesterol medication?
- C.
You don't smoke, do you?
- D.
A & C
- E.
None of the above
- 13.Following each Level II CMR/A, the patient must be provided their updated Personal Medication Record (PMR) and Medication Action Plan (MAP), which can be provided at the time of the visit or mailed to the patient afterward.
- A.
True
- B.
False
- 14.Patient: “I am just not willing to exercise four days a week right now.” Keeping good motivational interviewing techniques in mind, the correct health care provider response would be:
- A.
Okay, that is your decision. You do what you want.
- B.
I really wish you would reconsider. This really could help you so much.
- C.
Ok. What would you be willing to do right now?
- D.
Well, on a scale of 1-10, how ready are you to consider an exercise plan?
- 15.Patient: “I am only willing to exercise two days a week. That’s all I can fit in right now.” Keeping good motivational interviewing techniques in mind, the correct health care provider response would be:
- A.
Okay, let me know how it goes.
- B.
Twice a week would be a great start. What type of exercise do you think you will start with?
- C.
Well, ok...I guess I can accept that
- D.
That is your choice. Would you consider three times a week?
- 16.Patient: “OK… by the way… someone told me that this medicine can make you feel sluggish. Is that true? I don’t need that.” Keeping good motivational interviewing techniques in mind, the correct health care provider response would be:
- A.
Well, yes it can...but I wouldn't worry about it. It will go away.
- B.
Yes it can, but you want to get your blood pressure controlled, don't you?
- C.
It sounds like this side effect concerns you. May I share with you what some of my other patients have shared with me about their experience with this medication? (Yes) Some patients feel sluggish at first. This doesn't happen to everyone and these symptoms usually go away within a few days.
- D.
I doubt that will happen to you. I wouldn't worry about it.
- 17.What kinds of resources can you find on the PSW WPQC web portal to help with WPQC services?
- A.
Medication wallet cards for your patients to carry with them and share with their health care providers
- B.
Fax forms to inform physicians of the services you provided to the patient
- C.
Marketing tools to help inform patients about WPQC services
- D.
Motivational interviewing tips to help with apprehensive patients
- E.
All of the above
- 18.My pharmacy must provide both Level I and Level II services in order to be considered WPQC-accredited.
- A.
True
- B.
False
- 19.In addition to having pharmacists become WPQC-certified, it is recommended pharmacies have at least one WPQC-certified technician.
- A.
True
- B.
False
- 20.Follow-Up visits to the CMR/A can be submitted ______ times annually.
- A.
4
- B.
3
- C.
6
- D.
0
- 21.Mr. Todd was discharged from the local hospital last week following a hypoglycemic episode which caused him to fall and break his left hip. You are quite familiar with Mr. Todd because his medications have changed many times over the past year. He has come to really enjoy and value his “medication check-ups,” and has had four sit down visits with you so far in the past 10 months. This time, you note multiple discrepancies on his discharge orders that require much effort to resolve for him. You spend additional time with Mr. Todd explaining these items, reviewing his understanding of the changes, checking in on how he managed his diabetes (including medication adherence) prior to the fall, developing a plan that might help him to avoid such hypoglycemic events in the future, and provide him an updated PMR and MAP. You also communicate to his physicians the interventions that you have made. Can you submit a WPQC claim for this service?
- A.
No. He already has had his 4 Level II visits for the year.
- B.
No. This was not a true CMR/A.
- C.
Yes. He was discharged last week.
- D.
Yes. He has diabetes.
- 22.“Your insurance company said I had to switch your medication” is an appropriate way to communicate a Level I service opportunity to a patient.
- A.
True
- B.
False
- 23.Technician roles for WPQC may include the following:
- A.
Flagging prescriptions for potential level I opportunities
- B.
Promoting the program to patients on intake or at the consultation area
- C.
Providing reminder calls to patients for upcoming CMR/As
- D.
Making CMR/A follow-up appointments and helping patients fill out patient satisfaction surveys
- E.
All of the above
- 24.Which of the following is considered a billable Cost Effectiveness Level I intervention?
- A.
Switching from Prilosec OTC to prescription omeprazole – it saves the patient money.
- B.
Switching a patient currently taking Diovan and hydrochlorothiazide to Diovan HCT – now they only have to take one pill instead of two.
- C.
Switching a patient currently taking fexofenadine (covered by the health plan's formulary) for allergies to OTC loratadine.
- D.
All of the above
- 25.An intervention push comes through to your pharmacy flagging a patient with a medication profile consisting of simultaneous refills for atorvastatin 40 mg and Vytorin 10/40. The pharmacist realizes this is an opportunity for which Level I service?
- A.
Medication deletion, these are duplicate therapies
- B.
Medication addition, the current hyperlipidemia guidelines suggest an additional medication is indicated for this patient
- C.
Cost effectiveness, the Vytorin can be changed to 2 generic medications
- D.
Focused adherence, the patient is taking these medications incorrectly
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