A survey of pharmacists' roles in gastroenterology and hepatology

Abstract

IntroductionPharmacists' roles have evolved over time to include direct patient care and optimization of medication related outcomes. However, one therapeutic area lacking an evaluation of pharmacist involvement is gastroenterology and hepatology (GI/liver). This area utilizes biologics and other treatment options with considerable cost and safety, thus pharmacists can have a significant impact in caring for patients with GI/liver conditions.ObjectivesIdentify the background training of pharmacists practicing in GI/liver and characterize their current practice landscape.MethodsA survey was developed and disseminated through the American College of Clinical Pharmacy (ACCP) GI/Liver/Nutrition and Ambulatory Practice and Research Networks (PRN) groups and through the American Society of Health System Pharmacists (ASHP) Section of Specialty Pharmacy Practitioners from November 30, 2020 to January 16, 2021.ResultsOf 42 unique responses received, respondents primarily practiced at an academic medical center in the ambulatory setting. Although respondents reported completing various types of post‐graduate training (residency and fellowship), 55% of respondents endorsed prior exposure to GI/liver during training. Common disease states managed were inflammatory bowel disease, hepatitis B and C, and cirrhosis. Half of respondents reported having a collaborative practice agreement and 67% reported independently seeing patients in clinic, developing therapy plans, and ordering/monitoring labs. Approximately 69% do not have dedicated time for research. Only 23% of respondents reported billing for clinical services.ConclusionIn this survey, pharmacists are involved in caring for patients with GI/liver conditions under collaborative practice agreements and primarily based in an outpatient clinic. Future growth of pharmacists in this therapeutic space will require increased formalized training of GI/liver conditions and strategies to optimize reimbursement.

Role and Impact of a Clinical Pharmacy Team at an Inflammatory Bowel Disease Center

“…A previous study assessing pharmacists practicing in gastroenterology and hepatology clinic found that 23% of respondents conducted PAs independently without the assistance of clerical staff. 9 Pharmacy technicians are a vital part of the team as they aid in submitting PAs and contacting insurers for status determinations. Working alongside pharmacy technicians, clinical pharmacists are able answer clinical questions and appeal denials with letters of medical necessity or peer-to-peer reviews.…”

“…A previous survey completed by gastroenterology and hepatology pharmacists found that majority of pharmacists practice in an outpatient setting with 71% having clinic responsibility (either seeing patients independently or in a multidisciplinary clinic). 9 More than 60% of pharmacists develop therapeutic plans, order, and monitor labs, provide medication reconciliation as well as patient education. This study illustrates similar findings with clinical interventions predominately associated with therapy-related recommendations, patient education and lab monitoring for advanced IBD therapies.…”

“…However, outside of the IBD medical home model, pharmacists have demonstrated the impact they can make in improving safe and effective medication use. 9 …”