Pharmacist eConsult service for primary care medication optimization and safety

Smith, Marie; Vuernick, Erika; Anderson, Daren; Mulrooney, Mary; Harel, Ofer; Allotey, Prince Addo

doi:10.1016/j.japh.2021.01.006

Cited by 9 publications

(16 citation statements)

References 21 publications

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Mentioning

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“…Physicians submitted 90% of the pharmacy eConsult requests, compared with requests from advanced practice providers (10%); the majority came from the Palliative Care Service, which has more physicians than advanced practice providers (17 and 4, respectively). This contrasts with the findings of Smith et al, 10 in which advanced practice nurses were the predominant providers and sent 3 times the number of eConsults and questions compared with physician providers.…”

Section: Discussioncontrasting

confidence: 86%

“…The most common eConsults address drug-drug interactions, medication safety, and therapeutics. These medication-related issues align with those documented in the study by Smith et al 10 The average time to complete an eConsult in our program is more than 30 minutes because the pharmacists conduct a CMR, including a drug-drug interaction screen and a literature search for each consult. The pharmacy eConsult response includes a recommendation, alternative options, and evidence-based references.…”

Section: Discussionsupporting

confidence: 80%

“…Other pharmacy eConsult services in primary care, mental health, and pain management have been shown to improve access to care and medication optimization, both of which are goals of our pharmacy eConsult. 8,10,11…”

Section: Discussionmentioning

confidence: 99%

“…A study on the use of a pharmacist eConsult service independent of a DI service for medication-related questions was conducted within an existing physician specialist eConsult network for PCPs in a federally qualified health center. 10 During the 1-year evaluation period, a total of 57 eConsults containing 123 questions were answered. The most common question categories included adverse drug events/drug interactions, drug or dosage evaluations, and comprehensive medication review (CMR).…”

Section: Econsultsmentioning

confidence: 99%

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The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults

Clinard

Stebbins

Lynch

2021

Journal of Pharmacy Technology

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Drug information (DI) services provided an avenue to expand the role of pharmacists as the medication experts. The focus of DI has shifted from general questions submitted to DI centers to patient-specific questions that optimize care. One method to increase access to pharmacist expertise is through pharmacy eConsults. Pharmacy eConsults provide specialist care for medically complex patients using a patient-centered, asynchronous approach. The purpose of this article is to describe the evolution of consults from formal drug information services and describe one academic medical center’s implementation of a pharmacy eConsult service to provide patient-specific DI.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Econsultsmentioning

confidence: 99%

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The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults

Clinard

Stebbins

Lynch

2021

Journal of Pharmacy Technology

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“…Telehealth and electronic consultations (ie, eConsults) are emerging as strategies for pharmacists to provide direct patient care 31 and engage in population health and medication reconciliation initiatives. A few citations are available that describe pharmacists evaluating EHR data to identify at‐risk patients and making clinical recommendations to improve patient outcomes by addressing known side effects, such as B12 deficiency in patients taking metformin, as well as aiming to improve FQHC outcomes aligned with established metrics 63 . In one example, three Uniform Data System measures around pharmacologic therapy, asthma, and cardiovascular disease and one National Quality Forum measure for diabetes were used to identify out of range patients.…”

Section: Models and Tenets Of Pharmacist‐provided Carementioning

confidence: 99%

Pharmacist care in Federally Qualified Health Centers: A narrative review

Rodis

Irwin

Valentino

et al. 2022

J Am Coll Clin Pharm

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Federally Qualified Health Centers (FQHCs) are critical to providing care to underserved populations in the United States. Their focus on interprofessional care has also made FQHCs ideal locations to integrate pharmacists into care teams and advance pharmacy practice. However, despite long-standing involvement by pharmacists, there have been limited attempts to synthesize this literature. We conducted a comprehensive search for published literature on the roles of pharmacists in FQHCs and narrowed our search to 54 manuscripts and abstracts for inclusion in this narrative review. We found that pharmacists in FQHCs are providing care that is interprofessional, multifaceted, and evolving rapidly in response to environmental changes.Pharmacists are routinely involved in the traditional management of chronic disease, such as diabetes, hypertension, behavioral health, and respiratory conditions. In addition, pharmacists have forged roles in preventive care, infectious disease, and pain management. Models include appointment-based approaches; however, there was also heterogeneity in approaches consistent with the dynamic nature of the healthcare system in the United States with engagement in population health, transitions of care, and telehealth, as a few examples. Collaborative practice agreements were used to deliver care in some cases, although this was not commonplace, and reimbursement by third party payers was rarely addressed. Relationships with community pharmacies, often driven by the 340B Drug Pricing Program, were also noted.Recommendations for future research in this area include increasing the rigor of future research by standardizing pharmacy interventions and including comparator groups, a greater focus on financial sustainability, and further exploration of how state laws surrounding pharmacist provider status and scope of practice impact pharmacy service development.

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