Perceptions of Integration of the Clinical Pharmacist into the Patient Care Medical Home Model

McFarland, M. Shawn; Lamb, Kristen; Hughes, Jonathan; Thomas, Ashley M.; Gatwood, Justin; Hathaway, Jacob

doi:10.1097/jhq.0000000000000114

Cited by 27 publications

(24 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous literature has consistently shown the impact clinical pharmacists have in primary care when involved in CMM, 1‐10 particularly in VA medical centers. The integration of PACT CPS's into primary care in the VA has allowed for increased access for veterans to primary care services and has served to enhance the PCMH 11,12 . In an attempt to further improve access to primary care, clinical pharmacists have been at the forefront of implementing telehealth technology to enhance patient care, especially since the American College of Clinical Pharmacy (ACCP) published a white paper in 2018 encouraging utilization of telehealth in CMM to align with the Standards of Practice for Clinical Pharmacists 21 and provided guidelines for implementation and evaluation of telehealth practices 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Since the integration of clinical pharmacy specialists (CPS) into the patient‐centered medical home model (PCMH) known within the VA as patient‐aligned care team (PACT), literature has continued to show the impact CPS have in primary care when involved in comprehensive medication management (CMM) 1‐10 . The integration of PACT CPS into primary care in the VA has served to enhance the PCMH 11,12 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic

Thomas

Baker

Hoffmann

et al. 2021

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

Introduction The Veterans Affairs (VA) has been at the forefront of harnessing the skills of clinical pharmacy specialists (CPS) in patient‐aligned care teams (PACT) to improve patient care outcomes and create access for veterans. With the unfortunate arrival of Coronavirus disease 2019 (COVID19), PACT CPS were duty‐bound to expand telehealth services at an accelerated rate. The purpose of this quality improvement analysis is to compare CPS efficiency as well as some objective patient metrics to assess for a change in the quality of care. This is the first study to compare the efficiency and quality of care by CPS in the VA pre‐COVID19 and during the COVID19 pandemic. Methods This is a retrospective review of PACT CPS comprehensive medication management from 3/10/19 to 11/30/19 and 3/10/20 to 11/30/20. Data points focused on clinic encounters, patient accountability to appointments, disease state expansion, and markers of disease‐state management. Given diabetes and hypertension are the main disease states managed by most PACT CPS', the study evaluated changes in hemoglobin A1c (HbA1c) and blood pressure (BP) between the two cohorts as well. Data were analyzed using GraphPad Software or Microsoft Excel. A student T‐test was used for continuous data and Chi‐squared or Fishers Exact for nominal data. Results The total number of PACT CPS encounters increased 32% in 2020, and the number of unique patients increased by 12%. There were a statistically significant increase in telephone and direct‐to‐consumer (DCT) video visits. The rates of no shows and cancellations significantly decreased between 2019 and 2020. There was no difference in the average change in HbA1c or average blood pressure between the two study groups. Conclusions When PACT CPS services transitioned from primarily face‐to‐face visits to all virtual care, the consistency of care improved, and the quality of care was not compromised.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic

Thomas

Baker

Hoffmann

et al. 2021

J Am Coll Clin Pharm

Self Cite

View full text Add to dashboard Cite

show abstract

“…5 The added value of a clinical pharmacist was comparable to that in other settings where the pharmacist was perceived as an asset to the health care team owing to enhanced patient monitoring, providing education, clinician satisfaction, and access. 15,16 Typically, concierge practices are set up for physicians to have a smaller patient panel, to have the ability to spend more time with patients, and to provide whole patientebased care; these practices have been associated with a decrease in provider burnout and an increase in work satisfaction. 2,[17][18][19] This CPCP study site had a larger panel size than typical concierge panels.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the role and value of a clinical pharmacist in a concierge primary care clinic

Santiago¹,

Bingham²,

Vaffis³

et al. 2021

Journal of the American Pharmacists Association

View full text Add to dashboard Cite

Objective: To understand the perceived role and value of the clinical pharmacist in a southern Arizona concierge primary care practice (CPCP) by employees. Methods: Semistructured face-to-face interviews were conducted with health care team members employed by the CPCP site in December 2019 and January 2020 for this study. The interviews were audio recorded, transcribed, and thematically analyzed using an inductive approach with ATLAS.ti (version 7). A qualitative assessment was performed by 2 independent reviewers to identify the themes, which included clinical, economic, and humanistic outcomes. Results: Eleven CPCP employees were interviewed: physicians (n ¼ 2), a nurse practitioner (n ¼ 1), medical assistants (n ¼ 4), and administrative staff (n ¼ 4). The perceived role and value of the clinical pharmacist in this CPCP varied by employee position; yet, all expressed the pharmacist's positive impact on patient care. Five themes were identified. The most common pharmacist roles identified included providing medication knowledge to providers, preventing abuse of controlled substances, monitoring clinical response to medications and adverse drug events, aiding in prior authorizations, educating patients, and providing patient-centered care. Conclusion:These results demonstrate that the integration of a clinical pharmacist into a CPCP can be valuable. This study highlights that the pharmacist was positively received by the physicians and staff. This further supports the value of the pharmacist as a key interprofessional health care team member. Further study is warranted to assess the longitudinal impact of pharmacists' services in a CPCP.

show abstract

“…To provide more specialized care, the expanded team involves the core team members as well as clinical specialists, which includes a clinical pharmacy specialist (CPS), nutritionist, social worker, and mental health clinicians. Patients are referred to the CPS by the patient’s primary care physician when they require more specialized comprehensive medication management and can also be identified utilizing VA-based population management tools [ 43 ]. A CPS has an expanded scope of practice within the VA, involving them in direct patient care roles, including those focused on inpatient care, primary care, mental health services, and pain, and granting them advanced practice provider status, which authorizes them to perform medication optimization services with prescriptive authority.…”

Section: Methodsmentioning

confidence: 99%

Impact of pharmacy services on initial clinical outcomes and medication adherence among veterans with uncontrolled diabetes

Gatwood

Chisholm-Burns

Davis

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundDiabetes remains a growing public health threat but evidence supports the role that pharmacists can play in improving diabetes medication use and outcomes. To improve the quality of care, the Veterans Health Administration has widely adopted care models that integrate clinical pharmacists, but more data are needed to interpret the impact of these services. Our objective was to assess clinical pharmacy services’ impact on outcomes and oral antidiabetic medication (OAD) use among veterans with uncontrolled diabetes in the first year of therapy.MethodsThis was a retrospective cohort analysis using the Veterans Affairs (VA) Corporate Data Warehouse to identify the first diagnosis of and initiation of OAD therapy for uncomplicated, uncontrolled diabetes (A1C > 7.0%) during 2002–2014. Receipt of clinical pharmacy services was identified using codes within VA electronic health records, and clinical values were obtained at or near the initial fill date and 365 days later. Use of OADs was assessed by proportion of days covered (PDC) for one year following the first filled prescription. Veterans having received clinical pharmacy services were matched 1:1 to those having not seen a clinical pharmacist in the first year of therapy, and generalized linear models assessed changes and differences in outcomes.ResultsThe analysis included 5749 patients in each cohort. On average, patients saw a clinical pharmacist 2.5 times throughout the first year of OAD therapy. Adherence to OAD medications was higher in veterans having seen a pharmacist (84.3% vs. 82.4%, p < 0.0001) and more such patients achieved a PDC of at least 80% (72.2% vs. 68.2%, p < 0.0001). After one year of OAD therapy, mean change in hemoglobin A1C was greater among those receiving pharmacy services (− 1.5% vs. -1.4%, p < 0.0001).ConclusionPharmacist participation in diabetes patients’ primary care positively affects the multifaceted needs of patients with this condition and comorbid chronic disease.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3665-x) contains supplementary material, which is available to authorized users.

show abstract

Perceptions of Integration of the Clinical Pharmacist into the Patient Care Medical Home Model

Abstract: This study evaluated the perceptions of clinical pharmacist integration into the PACT model. Respondents perceived clinical pharmacist beneficial.

Cited by 27 publications

References 12 publications

Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic

Clinical pharmacy specialists providing consistent comprehensive medication management with increased efficiency through telemedicine during the COVID19 pandemic

Evaluating the role and value of a clinical pharmacist in a concierge primary care clinic

Impact of pharmacy services on initial clinical outcomes and medication adherence among veterans with uncontrolled diabetes

Contact Info

Product

Resources

About