Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection

Gilbert, Elise M.; Gerzenshtein, Lana

doi:10.2146/ajhp150701

Cited by 16 publications

(12 citation statements)

References 8 publications

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“…Gilbert in 2016 and Barnes in 2020, in terms of adherence rate, VL, and CD4 count in clinics-highlighting the impact of HIVtrained pharmacists embedded in clinical services. 23,24 In our study, the high level of PLHIV with undetectable HIV VL (nearly 90%) is maintained whatever the mode of dispensing. Despite this high level, the large acceptance of the patient medication file (80%) might encourage pharmacists and compel them to offer more clinical activity as patients will age and be prescribed treatments for comorbidities.…”

Section: Concerns About Medication File Were Well Examined Bysupporting

confidence: 49%

Pharmacist’s role in HIV care in France. Implication for clinical improvement of people living with HIV worldwide

Jacomet

Langlois²,

Sécher³

et al. 2020

Pharmacology Res & Perspec

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Section: Concerns About Medication File Were Well Examined Bysupporting

confidence: 49%

Pharmacist’s role in HIV care in France. Implication for clinical improvement of people living with HIV worldwide

Jacomet

Langlois²,

Sécher³

et al. 2020

Pharmacology Res & Perspec

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“…Technicians and support personnel with experience in billing and coding have been used in specialty pharmacies to support daily operations . In addition to managing the prior authorization process, technicians assist with financial assessments, coordinate case management activities, facilitate refill and medication delivery, document education in the electronic medical record, and assist with adherence monitoring …”

Section: Recommendation 4: Incorporate Support Personnel Into Ancillamentioning

confidence: 99%

“…Studies of both the clinical outcomes and the economic impact of incorporating support personnel into clinical pharmacy services will justify the expansion of their roles while supporting the triple aim of improving quality, improving health, and reducing costs. Current evidence suggests that incorporating pharmacy technicians and other support personnel into the process of care increases the pharmacist's time to engage in CMM and decreases wasted medications, resulting in substantial cost savings without compromising quality . However, the impact of this evidence is limited, given that most of the studies were single‐center investigations.…”

Section: Recommendation 5: Conduct and Disseminate Research On The Utmentioning

confidence: 99%

“…32,86 In addition to managing the prior authorization process, technicians assist with financial assessments, coordinate case management activities, facilitate refill and medication delivery, document education in the electronic medical record, and assist with adherence monitoring. 51,86,87 To support quality improvement activities and pharmacy operations, data analyst functions performed by support personnel include running monthly reports on drug use patterns to assess financial impact, compiling and administering satisfaction surveys to obtain feedback on clinical pharmacy services, and assessing outcomes of institutional initiatives and quality improvement reporting. 53 A technician informaticist with skills in developing, maintaining, and using systems and databases can help streamline workflows, test reporting functionalities, and teach others in the institution how to use the technology systems in support of medication use safety policies.…”

Section: Documentationmentioning

confidence: 99%

“…Study identified appropriate administrative and clinical roles for CPTs and advanced practice CPTs in an anticoagulation clinic through the Delphi process48 • Clinical pharmacy technicians have been used in anticoagulation management, therapeutic interchange, medication box clinic, patient triage, clinic inspections, and clinic support 50 • Pharmacy technicians improved continuity of care and facilitated medication adherence in specialty clinics by enrolling patients in the benefit program, completing prior authorizations, and setting up copay assistance programs51 …”

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confidence: 99%

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Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist's process of care

Borchert

Phillips

Bastin

et al. 2018

J Am Coll Clin Pharm

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Changes to the U.S. health care landscape have increased the focus on the quality and use of alternative payment models, with a growing focus on value. As health care costs continue to rise, clinical pharmacists will increasingly engage in roles to expand the breadth and depth of clinical services in providing comprehensive medication management (CMM) to improve patient outcomes. The roles of pharmacy technicians and other support personnel must evolve to meet the needs created by this practice change and allow pharmacists to focus their services on activities that use their expertise to improve medication outcomes. Support personnel, including pharmacy technicians, should be identified to assist with clinical pharmacy tasks on the basis of their skills. To ensure competence, support personnel should be adequately trained and (if applicable) certified. Moreover, support personnel should be optimally incorporated into appropriate components of the clinical pharmacist's process of care to expand the reach and depth of clinical pharmacy services. When supervised by the pharmacist or others as defined in state practice acts, support personnel may be able to assist in the clinical pharmacist's provision of CMM. Finally, research should be conducted and disseminated on the utility and outcomes achieved using support personnel in the clinical pharmacist's process of care.

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Clinician Specialty and HIV PrEP Prescription Reversals and Abandonments

Bakre,

Chang,

Doshi

et al. 2024

JAMA Intern Med

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ImportanceClinicians are a key component of preexposure prophylaxis (PrEP) care. Yet, no prior studies have quantitatively investigated how PrEP adherence differs by clinician specialty.ObjectiveTo understand the association between prescribing clinician specialty and patients not picking up (reversal/abandonment) their initial PrEP prescription.Design, Setting, and ParticipantsThis cross-sectional study of patients who were 18 years or older used pharmacy claims data from 2015 to 2019 on new insurer-approved PrEP prescriptions that were matched with clinician data from the US National Plan and Provider Enumeration System. Data were analyzed from January to May 2022.Main Outcomes and MeasuresClinician specialties included primary care practitioners (PCPs), infectious disease (ID), or other specialties. Reversal was defined as a patient not picking up their insurer-approved initial PrEP prescription. Abandonment was defined as a patient who reversed and still did not pick their prescription within 365 days.ResultsOf the 37 003 patients, 4439 (12%) were female and 32 564 (88%) were male, and 77% were aged 25 to 54 years. A total of 24 604 (67%) received prescriptions from PCPs, 3571 (10%) from ID specialists, and 8828 (24%) from other specialty clinicians. The prevalence of reversals for patients of PCPs, ID specialists, and other specialty clinicians was 18%, 18%, and 25%, respectively, and for abandonments was 12%, 12%, and 20%, respectively. After adjusting for confounding, logistic regression models showed that, compared with patients who were prescribed PrEP by a PCP, patients prescribed PrEP by ID specialists had 10% lower odds of reversals (odds ratio [OR], 0.90; 95% CI, 0.81-0.99) and 12% lower odds of abandonment (OR, 0.88; 95% CI, 0.78-0.98), while patients prescribed by other clinicians had 33% higher odds of reversals (OR, 1.33; 95% CI, 1.25-1.41) and 54% higher odds of abandonment (OR, 1.54; 95% CI, 1.44-1.65).ConclusionThe results of this cross-sectional study suggest that PCPs do most of the new PrEP prescribing and are a critical entry point for patients. PrEP adherence differs by clinician specialties, likely due to the populations served by them. Future studies to test interventions that provide adherence support and education are needed.

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Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection

Abstract: Integration of specialty pharmacy services with the interdisciplinary care provided in the outpatient NM ID clinic has enhanced continuity of care for patients with HIV infection in terms of prescription filling, medication counseling, and adherence monitoring.

Cited by 16 publications

References 8 publications

Pharmacist’s role in HIV care in France. Implication for clinical improvement of people living with HIV worldwide

Pharmacist’s role in HIV care in France. Implication for clinical improvement of people living with HIV worldwide

Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist's process of care

Clinician Specialty and HIV PrEP Prescription Reversals and Abandonments

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