Development of a Pharmacist REferral Program in a primary cARE clinic (PREPARE): A prospective cross-sectional study

Barry, Arden R.

doi:10.1177/1715163517702167

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…The majority of referrals were placed for general medication review. 20 Thus, depending on the provider-pharmacist relationship and practice setting, some providers place a higher value or perceive a greater need for the other services clinical pharmacists provide (e.g., review of patients’ medication regimens, assessment of drug interactions, assistance with adverse effect management, or optimization of adherence) over focused management for specific chronic diseases. Alternatively, the providers who value pharmacists assisting with focused disease management can be influenced to either accept or reject clinical pharmacy services because of additional factors such as patient complexity and personal comfort with disease management.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the acceptance of referrals for clinical pharmacist managed disease states in primary care

Bhat¹,

Kroehl²,

Yi³

et al. 2019

Journal of the American Pharmacists Association

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Objective: Clinical pharmacists use population health methods to generate chronic disease management referrals for patients with uncontrolled chronic conditions. The purpose of this study was to compare primary care providers’ (PCPs) referral responses for 4 pharmacist-managed indications and to identify provider and patient characteristics that are predictive of PCP response. Design: Retrospective cohort study. Setting: This study occurred in an academic internal medicine clinic. Participants: Clinical pharmacy referrals generated through a population health approach between 2012 and 2016 for hypertension, chronic pain, depression, and benzodiazepine management were included. Main outcome measures: Proportion of referrals accepted, left pending, or rejected and influencing provider and patient characteristics. Results: Of 1769 referrals generated, PCPs accepted 869 (49%), left pending 300 (17%), and rejected 600 (34%). Compared with referrals for hypertension, benzodiazepine management, and depression, chronic pain referrals had the lowest likelihood of rejection (odds ratio [OR] 0.31; 95% CI 0.19–0.49). Depression referrals had an equal likelihood of being accepted or rejected (OR 1.04; 95% CI 0.66–1.64). Provider characteristics were not significantly associated with referral response, but residents were more likely to accept referrals. Patient characteristics associated with lower referral rejection included black race (OR 0.39; 95% CI 0.18–0.87), higher systolic blood pressure (OR 0.98; 95% CI 0.97–0.99), and missed visits (OR 0.24; 95% CI 0.07–0.81). Conclusion: The majority of referrals for clinical pharmacists in primary care settings were responded to, varying mostly between acceptance and rejection. There was variability in referral acceptance across indications, and some patient characteristics were associated with increased referral acceptance.

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Section: Discussionmentioning

confidence: 99%

Factors influencing the acceptance of referrals for clinical pharmacist managed disease states in primary care

Bhat¹,

Kroehl²,

Yi³

et al. 2019

Journal of the American Pharmacists Association

View full text Add to dashboard Cite

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“…[1][2][3][4][5][6] Furthermore, reports in the Canadian Pharmacists Journal have described the successful implementation of dedicated consultation services to deliver high-quality pharmacist-led interventions in primary care and geriatric tertiary care in the outpatient setting. 7,8 The objective of this study was to describe the first 12 months of a pharmacist-led internal medicine outpatient consult service and characterize its implementation, patient population and interventions made by pharmacists.…”

Section: Introductionmentioning

confidence: 99%

Development of a pharmacist-led internal medicine outpatient consult service

et al. 2021

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“…Pharmacist involvement in the medication management of other chronic disease states is well established, particularly within the primary care setting . Increasing examples of pharmacist‐led clinics have been described, with multiple publications evaluating pharmacist‐managed care within the veteran population .…”

Section: Introductionmentioning

confidence: 99%

Interventions associated with implementation of a pharmacist‐led neurology pharmacotherapy clinic in an ambulatory care setting

Martin

Heberle

Knight

2018

J Am Coll Clin Pharm

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Objectives Medication management of neurologic disorders can present challenges in an ambulatory care setting. Clinical pharmacy specialists (CPSs) may be uniquely positioned to assist with the medication adjustments and monitoring that is often necessary for these conditions. While pharmacist‐led clinics are well established in some areas of ambulatory care, few examples have been described within neurology. This project aims to describe the interventions associated with a pharmacist‐led neurology clinic within a Veterans Affairs (VA) Medical Center. Methods A pharmacist‐led neurology clinic was implemented to assist with medication management of various neurologic conditions and increase access to the neurology service. This retrospective chart review included patients referred to the CPS clinic during a 6‐month period, with a minimum follow‐up of 3 months. The number of medication changes, nonpharmacologic interventions, and adverse drug events (ADEs) managed by the CPS was determined. The number of interim pharmacist‐led visits was used as an estimate of neurology provider time saved. Results One hundred sixty‐four patients were included in the analyses. During the 9‐month period assessed, patients had a total of 307 visits in the pharmacist‐led neurology clinic. Patients were referred for multiple neurologic conditions, with headache, neuropathy, Parkinson's disease, non‐Parkinson's tremor, and seizure disorders being the most common. The CPS made 175 dose adjustments, 139 medication additions or discontinuations, and 135 nonpharmacologic interventions. In addition, 41 ADEs were identified and/or managed during CPS encounters. Patients had an average of two visits with the CPS in between scheduled neurology clinic appointments; this allowed for an estimated 34 appointment slots/month to remain open in the neurology provider clinics. Conclusions The implementation of a pharmacist‐led neurology clinic allowed for CPS management of medications for multiple neurologic conditions, including the management of ADEs, and increased access to the neurology ambulatory care service at this VA facility.

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Development of a Pharmacist REferral Program in a primary cARE clinic (PREPARE): A prospective cross-sectional study

Cited by 4 publications

References 20 publications

Factors influencing the acceptance of referrals for clinical pharmacist managed disease states in primary care

Factors influencing the acceptance of referrals for clinical pharmacist managed disease states in primary care

Development of a pharmacist-led internal medicine outpatient consult service

Interventions associated with implementation of a pharmacist‐led neurology pharmacotherapy clinic in an ambulatory care setting

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