Evaluation of clinical pharmacy interventions in a Veterans Affairs medical center primary care clinic

Hough, Augustus; Vartan, Christine M.; Groppi, Julie; Reyes, Sonia; Beckey, Nick P.

doi:10.2146/ajhp120514

Cited by 17 publications

(13 citation statements)

References 5 publications

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“…5 This is important work that shows great promise. However, qualitative research methods can identify and describe kinds of care that may be hard to measure and characterize, but which nonetheless adds a great deal to patient care.…”

Section: Discussionmentioning

confidence: 99%

“…4 While there are tools in development to measure CPSs contribution to care, the results from these quantitative tools have yet to be fully analyzed and published. 5 A growing body of literature has described the contributions of outpatient clinical pharmacy to patient care, including comprehensive medication management, patient counseling, and health professional education with the intent of improving patient processes of care and clinical outcomes. [6][7][8][9] Indeed, literature in pharmacy notes that incorporating direct patient care by pharmacists would be an appropriate and effective enhancement for US health care.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Knowing the patient: A qualitative study on care-taking and the clinical pharmacist-patient relationship

McCullough

Petrakis

Gillespie

et al. 2016

Research in Social and Administrative Pharmacy

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Knowing the patient: A qualitative study on care-taking and the clinical pharmacist-patient relationship

McCullough

Petrakis

Gillespie

et al. 2016

Research in Social and Administrative Pharmacy

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“…The DIIs that pharmacists in this practice setting addressed are often associated with avoidable healthcare costs. As an example, an economic evaluation of pharmacy services conducted in a Veterans Affairs setting suggested that 400 to 2000 USD in additional outpatient costs can be avoided for each resolved untreated or undertreated indication, adverse reaction, inappropriate dose, or drug interaction [29]. The drug classes most commonly encountered by pharmacists responding to DIIs in this study are frequently associated with drug-related emergency department visits and hospitalizations [4,5,[30][31][32].…”

Section: Discussionmentioning

confidence: 80%

Prescriber-Initiated Engagement of Pharmacists for Information and Intervention in Programs of All-Inclusive Care for the Elderly

Bankes¹,

Schamp²,

Knowlton³

et al. 2020

Pharmacy

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Little is known about the types of drug information inquiries (DIIs) prescribers caring for older adults ask pharmacists during routine practice. The objective of this research was to analyze the types of DIIs prescribing clinicians of Programs of All-Inclusive Care for the Elderly (PACE) made to clinical pharmacists during routine patient care. This was a retrospective analysis of documented pharmacists’ encounters with PACE prescribers between March through December, 2018. DIIs were classified using a developed taxonomy that describes prescribers’ motivations for consulting with pharmacists and their drug information needs. Prescribers made 414 DIIs during the study period. Medication safety concerns motivated the majority of prescribers’ inquiries (223, 53.9%). Inquiries received frequently involved modifying drug therapy (94, 22.7%), identifying or resolving adverse drug events (75, 18.1%), selecting or adjusting doses (61, 14.7%), selecting new drug therapies (57, 13.8%), and identifying or resolving drug interactions (52, 12.6%). Central nervous system medications (e.g., antidepressants and opioids), were involved in 38.6% (n = 160) of all DIIs. When answering DIIs, pharmacists made 389 recommendations. Start alternative medications (18.0%), start new medications (16.7%), and change doses (12.1%) were the most frequent recommendations rendered. Prescribers implemented at least 79.3% (n = 268) of recommendations based on pharmacy records (n = 338 verifiable recommendations). During clinical practice, PACE prescribers commonly ask pharmacists a variety of DIIs, largely related to medication safety concerns. In response to these DIIs, pharmacists provide medication management recommendations, which are largely implemented by prescribers.

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“…All CPS interventions were collected and tracked via the PharmD tool7 in the patient's electronic medical record. The PharmD tool is a reminder dialog template with embedded health factors used nationally throughout the VA health care system to document clinical pharmacy interventions made during patient care encounters.…”

Section: Methodsmentioning

confidence: 99%

Implementation and evaluation of Parkinson disease management in an outpatient clinical pharmacist–run neurology telephone clinic

Stefan

Elharar

García

2018

Mental Health Clinician

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Parkinson disease (PD) is a progressive, debilitating neurodegenerative disease that often requires complex pharmacologic treatment regimens. Prior to this clinic, there was no involvement of a clinical pharmacy specialist (CPS) in the outpatient neurology clinic at the West Palm Beach Veterans Affairs Medical Center. This was a prospective, quality-improvement project to develop a clinical pharmacist–run neurology telephone clinic and evaluate pharmacologic and nonpharmacologic interventions in an effort to improve the quality of care for patients with PD. Additionally, the CPS conducted medication education groups to 24 patients with PD and their caregivers, if applicable, at this medical center with the purpose of promoting patient knowledge and medication awareness. Medication management was performed via telephone rather than face to face. Only patients with a concomitant mental health diagnosis for which they were receiving at least one psychotropic medication were included for individual visits due to the established scope of practice of the CPS being limited to mental health and primary care medications. Data collection included patient and clinic demographics as well as pharmacologic and nonpharmacologic interventions made for patients enrolled from January 6, 2017, through March 31, 2017. A total of 49 pharmacologic and nonpharmacologic interventions were made for 10 patients. We successfully implemented and evaluated a clinical pharmacist–run neurology telephone clinic for patients with PD. Expansion of this clinic to patients with various neurological disorders may improve access to care using an innovative method of medication management expertise by a CPS.

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Evaluation of clinical pharmacy interventions in a Veterans Affairs medical center primary care clinic

Cited by 17 publications

References 5 publications

Knowing the patient: A qualitative study on care-taking and the clinical pharmacist-patient relationship

Knowing the patient: A qualitative study on care-taking and the clinical pharmacist-patient relationship

Prescriber-Initiated Engagement of Pharmacists for Information and Intervention in Programs of All-Inclusive Care for the Elderly

Implementation and evaluation of Parkinson disease management in an outpatient clinical pharmacist–run neurology telephone clinic

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