Purpose Opioid use and overdose are epidemic in the United States. While there is concern regarding the abuse of illegal opioids, overdose is also strongly associated with prescription opioids. The Centers for Disease Control and Prevention supports coprescribing of naloxone with opioids; however, a review of naloxone prescriptions recorded within a primary care group indicated limited use of the reversal agent. Methods Through the collaboration of pharmacy and information services personnel, a report was created to identify all patients receiving chronic opioid therapy. To assess the risk of overdose, a validated risk scoring method was used. If patients were determined to be at high risk for overdose, outreach by a clinical pharmacist was conducted to educate them on the benefits of naloxone. For patients agreeable to receiving naloxone, prescriptions were entered into the electronic health record for primary care provider (PCP) verification. Contact was made following order verification to ensure patient understanding of proper naloxone use and naloxone accessibility. Results Prior to the project (ie, in calendar year 2016), only 5 prescriptions for naloxone had been prescribed within the medical group. During the naloxone coprescribing initiative, 230 patients were identified by clinical pharmacists as being at elevated risk for opioid overdose. Of these, 86 (37%) were deemed ineligible for naloxone. Out of the 144 patients determined to be eligible, 63 (44%) were agreeable to receiving naloxone. Further review determined that 7 additional patients were agreeable after a follow-up conversation with their PCP. Of the patients that agreed to receive naloxone, 48 (76%) confirmed that they had picked up naloxone from their pharmacy. Conclusion The naloxone coprescribing initiative was an innovative project that focused on an epidemic that affects communities across the United States. This program embraced the strengths of multiple departments for the good of the patient, in keeping with the idea of team-based care. The pharmacy-driven approach highlighted the importance of having pharmacists within an ambulatory care setting and allowed high-level pharmacist practice without adding to the workload of other members of the healthcare team.

No abstract

IntroductionData specific to pharmacists' value in patient‐provided clinical services in New York are limited due to their scope of practice restrictions. However, due to the coronavirus disease 2019 (COVID‐19) pandemic, there has been an expansion of telehealth and allowance for billable services for pharmacists.ObjectivesThe objective of this study was to complete a retrospective review to assess reimbursement of clinical services provided by pharmacists via telehealth during the pandemic in a primary care setting.MethodsA report was generated which identified patients 18 years and older, who were provided services by pharmacists within a primary care group via telehealth during March to July 2020 in New York. It identified patients with an appointment type code of “PharmD Telemed 30” or “PharmD TM Follow UP 15,” including Medicare Annual Wellness Visits or AWVs (G0438‐G0439) with procedural codes, and incident‐to CPT codes (99211‐99214). Information received included medical record number, name, date of birth, carrier plan name, billed procedure code and description, carrier payment amount, and patient responsible amount.ResultsA total of 485 patients were provided services during the timeframe. There were 223 encounters billed for the 99 211 CPT code, 156 of which received payment from insurers with an average of $20.14. For initial and subsequent AWVs there were a total of 48 and 150 encounters, respectively, billed by the pharmacists. Forty‐one of the encounters billed as a G0438 received payment from insurers with an average of $175.75. One hundred thirty‐three of the encounters billed as a G0439 received payment from insurers with an average payment of $114.09.ConclusionThe results of this study provided insight into whether specific services or insurances should be targeted for payment of services. Expansion of these services could show improvement in patient care and can assist in gathering outcomes to better support pharmacists gaining provider status on the state and national level.

Background Glucagon-like peptide-1 receptor (GLP-1) agonists carry benefits and risks that must be evaluated prior to use and monitored throughout weight management therapy. Pharmacists possess the accessibility and extensive medication knowledge to evaluate and monitor the use of GLP-1 therapy in weight management patients. Objective Evaluate the clinical and financial impact of a pharmacist-directed weight management service utilizing GLP-1 receptor agonists in a family practice setting. Methods A retrospective cohort study including patients at 2 family practices, aged 18 and older, prescribed a weight management GLP-1 between October 1, 2021 and March 1, 2022 was performed. Patients who met inclusion and were prescribed a weight loss GLP-1 but were not managed by the clinical pharmacist were compared with the pharmacist cohort. Descriptive statistics and inferential statistics including an independent t-test were used in the data analysis. Results There were 46 and 39 patients identified in the clinical pharmacist and primary care physician cohorts respectively. Patients in the clinical pharmacist cohort achieved a mean body weight reduction of 9.32% compared to 5.11% body weight reduction for patients in the primary care physician cohort (P = 0.01). There were 63 months identified of inappropriate GLP-1 therapy deprescribed in the clinical pharmacist cohort resulting in an estimated cost savings of $101,985.66. Conclusions The implementation of a pharmacist-led weight management clinic in 2 family medicine offices resulted in a significant reduction in body weight and reduction in total costs to the healthcare system compared to patients receiving weight management services from their primary care physician alone.