Identifying patients likely to be referred for a clinical pharmacist intervention in a family medicine residency‐training clinic

Abstract

Introduction Little is known about patient populations within family medicine residency‐training clinics that should be targeted for clinical pharmacy interventions. The objective of this study was to identify patient characteristics associated with receiving an intervention by a clinical pharmacist. Methods This retrospective cohort study included 4870 patients aged 40 to 89 years with at least one office visit at the University of Colorado AF Williams Family Medicine clinic from August 1, 2014 to July 31, 2015. Electronic health record data were used to examine associations between 23 previously identified patient‐specific elements and receipt of a clinical pharmacist intervention. Presence of a clinical pharmacist consultation note in the patient's record in the past 12 months was evidence of an intervention. Multivariable logistic regression was used to estimate adjusted odds ratios. Results Four percent (n = 182) of patients received at least one clinical pharmacist intervention. Multivariable logistic regression indicated that ≥10 active medications, A1c ≥ 9%, hypertension, depression/anxiety/panic disorder, asthma, indication for anticoagulant therapy, hospitalization/emergency department visit in the last 30 days, age ≥ 65, and Medicaid/uninsured increased the likelihood of receiving a clinical pharmacist intervention, while non‐English speaking significantly decreased the likelihood of receiving a clinical pharmacist intervention. Patients with 7 or more elements were seven times more likely to have a clinical pharmacist intervention than patients with 6 or fewer items (odds ratio = 7.0, 95% confidence interval = 5.2‐9.5). Conclusions Patients with more elements were more likely to have received a clinical pharmacist intervention. The accumulation of these elements could be used for targeted population‐based clinical pharmacist activities in residency training clinics.