INTRODUCTION: Significant attention has been given to developing a consistent patient care process for providing comprehensive medication management (CMM). However, little research exists that examines the necessary supports to effectively manage a CMM practice. RESEARCH QUESTION OR HYPOTHESIS: (1) What are the essential components of CMM practice management? (2) How are these components being carried out in practice? STUDY DESIGN: Phenomenographic case study design. METHODS: CMM pharmacists from 36 participating primary care clinics across five states were divided into three similar cohorts. Semi-structured interviews were carried out with pharmacists from cohort one. Participants were asked to describe what they consider the essential components of CMM practice management and what these components look like in their practice. Themes were defined by two investigators and coded using NVivo. A descriptive practice assessment tool was developed from emergent themes. Using the think-aloud method, participants in cohorts two and three completed sections of the tool while verbalizing their thought process and providing feedback. This process led to simultaneous development and refinement of the tool as well as achieving content validity. Throughout tool development, a series of four focus groups with CMM managers occurred to obtain their perspectives on the essential components of practice management and their feedback on the tool. RESULTS: Five domains of CMM practice management emerged: (1) organizational support, (2) care team engagement, (3) care delivery processes, (4) evaluation of CMM program, and
(5) ensuring consistent and quality care. Each domain consists of two to three components for a total of 13 components. Each component contains several questions which form a 78-item descriptive practice management assessment tool. CONCLUSION: This is the first study to develop a framework for the practice management of CMM. Understanding CMM practice management and the components that define it is critical to enhancing and expanding the practice of CMM.