The Impact of Pharmaceutical Care Practice on the Practitioner and the Patient in the Ambulatory Practice Setting: Twenty-five Years of Experience

Abstract

This manuscript reviews 25 years of experience that include developing the practice of pharmaceutical care and initiating new practices. The impact this practice has on practitioners in the ambulatory setting is described as well as data that reflect its clinical and economic impact. There is a great need to prepare new practitioners to provide pharmaceutical care. A focused training program was developed and delivered to over 300 practitioners. The practitioners were prepared by providing direct patient care. They learned the philosophy of pharmaceutical care practice, to identify, resolve and prevent drug therapy problems, to document care using a specially designed software program called the Assurance Pharmaceutical Care program. The practitioners who participated in the training program reported that the average amount of time spent with patients increased three-fold, they now see four times more patients than prior to training, and the number of new patients referred by physicians increased nine-fold as a result of the program. These practitioners have now provided care to more than 25,000 patients in their practices. These data have now been consolidated and analyzed, and a portion of these results is reported here. The clinical and economic outcomes from 2,985 adult patients, who received pharmaceutical care between January, 2000 and December, 2003, are presented. At the first assessment by the pharmaceutical care practitioner, 61% of the patients had one or more drug therapy problems identified and resolved. This resulted in an improvement in the clinical status or maintaining a stable status in 83% of the patients. The health care savings realized from pharmaceutical care were $1,134,162. This represented a benefit to cost ratio of 2:1. Physicians who collaborate with pharmaceutical care practitioners have validated the work of the practitioners, and patients are recognizing the benefits of pharmaceutical care.

Effect of a 36-month Pharmaceutical Care Program on the Coronary Heart Disease Risk in Elderly Diabetic and Hypertensive Patients

“…As observed in the present study and in previously published research, pharmaceutical care represent an effective strategy for the resolution of drug-related problems, and solving drug-related problems significantly improved patients' clinical outcomes (10,12,13,23,39). Studies with higher rates of drug-related problem resolution tended to demonstrate more concrete improvements in the patients' clinical outcomes.…”

“…Our results indicated an 89.08% resolution rate of identified drug-related problems. Strand et al (23) were able to resolve 88.0% of their drug-related cases, while Sá-Borges et al (10) successfully resolved 62.7% of identified cases. These different resolution rates of drug-related problems may be attributable to different levels of clinical knowledge and skills between the pharmacists that performed pharmaceutical care, since our study and the study conducted by Strand et al (23) were carried out with pharmacists who had greater practice experience than the study conducted by Sá-Borges et al (10).…”

Reduction of cardiovascular risk in patients with metabolic syndrome in a community health center after a pharmaceutical care program of pharmacotherapy follow-up

“…Thus, as part of the multidisciplinary team providing pharmaceutical care, the pharmacist may improve patients' clinical status through pharmacotherapy follow-up, assisting with effective therapy and the prevention, detection and resolution of NOMs and helping to improve patient quality of life (Strand et al, 2004).…”

An elderly, urban population: Their experiences and expectations of pharmaceutical services in community pharmacies

“…No pilot study was done, due to the sample size and time constraints of this study. The researcher also used questions adapted from those used in other studies in the field of pharmaceutical services and pharmaceutical care (Strand, Cipolle, Morley, & Frakes, 2004;Volume, Farris, Kassam, Cox, & Cave, 2001).…”