Evaluation of a Pharmacist-Managed Hypertension Clinic in a Rural Primary Care Setting

Stallings, Ashley M; Dixon, C A; Carter, Amanda; Ali, A. N.; Herring, C. T.

doi:10.1177/0897190020926841

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…The average BP during our patients' last visit was <140/90 mm Hg, demonstrating BP goal achievement in an NP/PharmD-led clinic. This extends previous work showing that when a pharmacist is embedded into primary goal BP goals are achieved (Stallings et al, 2020). Furthermore, our results support a narrowing of range in BP for patients seen in this clinic.…”

Section: Discussionsupporting

confidence: 89%

Feasibility and efficacy of a nurse practitioner-and pharmacist-led hypertension clinic

Speed

Schneider

Stutzman

et al. 2022

J Am Assoc Nurse Pract

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Hypertension (HTN) affects over one third of adults in the United States. Blood pressure (BP) management and patient education are provided by physicians, advanced practice clinicians, pharmacists, and nurses. In the traditional medical/clinic model, physicians have provided and directed HTN care. However, advanced practice nurses and pharmacists are also well trained and positioned to manage HTN. The purpose of this study was to explore the feasibility of an HTN clinic, led by a nurse practitioner (NP) and PharmD, specifically analyzing if targeted HTN can be achieved in this setting. Registry data were used to analyze the initial and the most recent visit BP levels in patients who were seen in an NP/PharmD-led HTN clinic. Measures of central tendency and differences between initial and most recent visit were also compared. A total of 46 patients were included in this analysis. Data showed that there was no statistically significant difference in the first visit (144/86) and the most recent visit (138/84) BP (p = .26), but that there was a clinical trend in decreasing BP as well as narrowing of BP ranges and interquartile ranges between visit. The NP/PharmD-led clinic is feasible and can help lower BP and narrow ranges toward targeted BP.

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Section: Discussionsupporting

confidence: 89%

Feasibility and efficacy of a nurse practitioner-and pharmacist-led hypertension clinic

Speed

Schneider

Stutzman

et al. 2022

J Am Assoc Nurse Pract

View full text Add to dashboard Cite

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“…There is plenty of evidence to show the value that pharmacists can add to patient care, particularly in rural and underserved areas. For instance, rural pharmacists have been shown to improve vaccine accessibility, 25 hypertension management 26 and access to hormonal contraception. 27 Furthermore, a pharmacist prescribing for an ambulatory conditions or minor ailments program in Saskatchewan was associated with cost savings for the health care system as well as improved access for patients, 28 with a similar program currently under development for Ontario.…”

Section: Discussionmentioning

confidence: 99%

Geographic distribution of Ontario pharmacists: A focus on rural and northern communities

Timony¹,

Houle²,

Gauthier³

et al. 2022

Can Pharm J

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Introduction: Canadians living in rural and northern communities face particular health needs and challenges in accessing primary care services. Ontario pharmacists are increasingly able to optimize patient care with a broadening scope of practice; this was highlighted during the COVID-19 pandemic. This study explores the geographic distribution of pharmacists to evaluate their potential to deliver health care in rural and northern Ontario communities. Methods: A secondary analysis of the Ontario College of Pharmacists’ registry data was undertaken, with all Part A pharmacists who had at least 1 patient care practice site included in the analysis. Full-time equivalent (FTE) hours worked at each practice site were calculated and compared with the population distribution. Ratios of FTEs per 1000 residents by census subdivision (which represents communities) were calculated and compared by geography, north vs south and urban vs rural (further subdivided by metropolitan-influenced zones). Results: The greatest availability of pharmacist FTEs was found in urban communities (with slightly better availability in the north), whereas the lowest availability was found in the most rural communities. A more granular observation revealed that northern communities were more likely to have no local pharmacist access (72%) compared with southern communities (24%). Discussion: Rural and northern communities are underserved. Novel approaches to overcoming the rural pharmacist care gap include rural practice incentives, targeted enrollment of rural students, increased rural exposure in pharmacy schools and the utilization of new technologies such as telepharmacy and drone medication deliveries.

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“…Pharmacist‐managed clinics (PMCs) provide outpatient services such as medication therapy management (MTM), disease management and patient education 1 . Previous studies have shown that implementing MTM has a significant impact on enhancing medication adherence, improving clinical outcomes 2–9 and achieving cost‐effectiveness 10–14 …”

Section: What Is Known and Objectivementioning

confidence: 99%

A qualitative study on the development of pharmacist‐managed clinics in Taiwan

Wen

Chen

et al. 2021

J Clin Pharm Ther

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What is known and objective Pharmacist‐managed clinics (PMCs) are established to solve drug‐related problems and enhance the quality of care of ambulatory patients. Although the benefits of such services have been demonstrated, little is known about PMC operations, especially outside the United States. The aim of this study was to explore how PMCs were established and to discuss implementation issues of PMCs in Taiwan. Methods A purposive sample of pharmacists, pharmacy administrators and physicians involved with PMCs was recruited from hospitals of varying scales across Taiwan. Semi‐structured, individual interviews were conducted to understand the perceptions of the clinical service of PMCs. Interviews were transcribed verbatim and analysed by thematic analysis to find underlying themes. Results A total of 12 pharmacists, 5 pharmacy administrators and 3 physicians from 8 institutions were interviewed. Pharmacists spent 4 to 20 h per week at PMCs, and the practice experiences of PMC ranged from 1 to 6 years. PMCs have been provided in these institutions for 4 to 11 years with an average volume of 28 h and 25 patient visits weekly. Study participants described influential factors in establishing PMCs, including clinical expertise, attitude towards patient care and trust building with collaborating physicians. Operational concerns in implementing PMCs included role clarifications, manpower shortage, inadequate advanced training or certification, regulatory issues and a lack of service promotion. What is new and conclusion This research broadens the understanding of operating PMC services and reveals key requirements and concerns regarding the care model, which can be useful for other countries. Resolving perceived barriers and collecting other stakeholders’ perspectives may reinforce the integration of PMCs into patient care in the future.

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Evaluation of a Pharmacist-Managed Hypertension Clinic in a Rural Primary Care Setting

Cited by 7 publications

References 15 publications

Feasibility and efficacy of a nurse practitioner-and pharmacist-led hypertension clinic

Feasibility and efficacy of a nurse practitioner-and pharmacist-led hypertension clinic

Geographic distribution of Ontario pharmacists: A focus on rural and northern communities

A qualitative study on the development of pharmacist‐managed clinics in Taiwan

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