Objective: To evaluate the impact of incorporating pre-advanced pharmacy practice experience (pre-APPE) student pharmacists into three different population health management (PHM) projects.
Methods: The prospective quality improvement projects incorporated three third-year student pharmacists who developed and conducted individual PHM projects over the course of three to seven months. The projects included hypoglycemia screening, hepatitis C virus and human immunodeficiency virus screening, and statin use evaluations for atherosclerotic cardiovascular disease risk reduction. Under the guidance of a clinical pharmacist, students developed project materials, conducted patient chart reviews, and contacted patients to make interventions such as recommendations for therapy, ambulatory patient monitoring, patient education, and arranging provider follow-up. Student impact was evaluated through the number of patients screened, the number of eligible patients contacted, and the total number of interventions or recommendations made. Student time spent was tracked throughout the projects.
Results: Out of 244 patients screened, 198 patients met inclusion criteria and 162 patients were contacted or assessed by a student pharmacist. Students made a total of 319 interventions, including patient education (132), patient monitoring (132), pharmacotherapy recommendations (28), and arranging follow-up (27). On average students screened 33 patients per month, and, per patient, required 8.6 minutes for eligibility assessment and approximately 6 minutes for telephone interviews.
Conclusion: This report demonstrates that pre-APPE student pharmacists are well-equipped to design and implement PHM projects. Utilization of student pharmacists in similar PHM programs can expand the pharmacist’s impact on patient care in the ambulatory care setting.
Article Type: Original Research
Background: Recent literature findings suggest that opportunities exist to optimize testosterone replacement therapy management. Objective: To evaluate the impact of a pilot clinical pharmacist testosterone therapy management service in a Veterans Affairs primary care setting. Methods: A 6-month, single-clinic, prospective cohort quality improvement project included male patients with an active prescription for testosterone. Patients were excluded if they switched primary care providers or were managed by a specialty clinic. After diagnosis, primary care providers had the option of referring patients for clinical pharmacist testosterone replacement therapy management. The project investigated the impact of pharmacist management on adherence to guideline-defined baseline and therapeutic monitoring, prior authorization workload, time saved by primary care providers, and clinical pharmacist interventions. Results: Sixty patients split between pharmacist management (N = 35) and nonpharmacist management (N = 25) cohorts. Monitoring of baseline parameters was significantly improved with clinical pharmacist management (54% vs 20%, P = 0.0006). Improved baseline monitoring decreased prior authorization team workload as requests were approved on the first submission at a higher rate (100% vs 75.4%, P = 0.06). Pharmacist management increased therapeutic monitoring for assessing symptom improvement (96% vs 26%, P < 0.001), monitoring of testosterone levels (96% vs 61%, P = 0.003), and safety monitoring with complete blood counts (100% vs 83%, P = 0.04). A total of 42 pharmacist–patient encounters saved over 600 minutes of primary care provider time. Conclusion: Clinical pharmacist involvement enhances therapeutic monitoring for male hypogonadism leaving room for expansion of clinical pharmacy services within testosterone replacement therapy management.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.