2022 ASHP Survey of Health-System Specialty Pharmacy Practice: Clinical Services

Abstract

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Results of the first ASHP national survey of clinical services provided by health-system specialty pharmacies (HSSPs) are presented. Methods A survey questionnaire was developed by 26 HSSP contacts after reviewing available literature on the role and services of HSSPs. After pilot and cognitive testing resulting in a final questionnaire of 119 questions, a convenience sample of 441 leaders in HSSPs was contacted using email and invited to participate in the survey. Results The survey response rate was 29%. Almost half of respondents (48%) had offered pharmacy services for 7 years or more, and most (60%) dispensed more than 15,000 prescriptions annually. Respondents most commonly (42%) reported a specialist model wherein staff are dedicated to specific specialty disease states. Over half of respondents reported providing several medication access, pretreatment assessment, and initial counseling services to patients referred to them, regardless of whether the HSSP was used for medication fulfillment. All HSSP activities were noted to be documented in the electronic health record and visible to providers frequently or always. Almost all respondents noted that HSSP pharmacists have a role in specialty medication selection. Disease-specific outcomes were tracked in 95% of responding HSSPs, with 67% reporting that outcomes were used to drive patient monitoring. HSSPs were often involved in continuity of care services such as transitions of care (reported by 89% of respondents), referral to other health-system services (53%), and addressing social determinants of health (60%). Most respondents (80%) reported providing clinical education to specialty clinic staff, including medicine learners (62%). Though only 12% of respondents had dedicated outcomes research staff, many reported annually publishing (47%) or presenting (61%) outcomes research Conclusion HSSPs are a clinical and educational resource for specialty clinics and have developed robust patient care services that encompass the patient journey from before specialty medication selection through treatment monitoring and optimization.

Realizing the Potential of Social Determinants Data: A Scoping Review of Approaches for Screening, Linkage, Extraction, Analysis and Interventions

“…Meanwhile, 4 studies investigated the potential for enhancing resource allocation through surveying outcomes. The improvement objectives encompassed the allocation of staff and equipment [221], the enhancement of patient navigation [224], and the transformation of health service practices [226,238].…”

“…Health outcomes, such as improvements in health metrics, reductions in disease incidence, changes in vital signs, and quality of life, are commonly used as measures to determine the feasibility of initiating an intervention (n = 10). Several studies have also assessed social SDoH in relation to patient satisfaction and acceptability [230,235,237,238]. Since most programs were new efforts, it was not possible to determine the effectiveness of the intervention in the short term, nor could the potential generalizability be assessed.…”