Physician experiences with clinical pharmacists in primary care teams

Abstract

a b s t r a c tBackground: Improving medication management is an important component of comprehensive care coordination for health systems. The Managing Your Medication for Education and Daily Support (MyMeds) medication management program at the University of California Los Angeles addresses medication management issues by embedding trained clinical pharmacists in primary care practice teams. Objectives: The aim of this work was to examine and explore physician opinions about the clinical pharmacist program and identify common themes among physician experiences as well as barriers to integration of clinical pharmacists into primary care practice teams. Methods: We conducted a mixed quantitativeequalitative methods study consisting of a crosssectional physician survey (n ¼ 69) as well as semistructured one-on-one physician interviews (n ¼ 13). Descriptive statistics were used to summarize survey responses, and standard qualitative content-analysis methods were used to identify major themes from the interviews. Results: The survey response rate was 61%; 13 interviews were conducted. Ninety percent of survey respondents agreed or strongly agreed that having the pharmacist in the office makes management of the patient's medication more efficient, 93% agreed or strongly agreed that pharmacist recommendations are clinically helpful, 71% agreed or strongly agreed that having access to a pharmacist has increased their knowledge about medications they prescribe, and 75% agreed or strongly agreed that having a pharmacist as part of the primary care team has made their job easier. Qualitative interviews corroborated survey findings, and physicians highlighted the value of the clinical pharmacist's communication, team care and expanded roles, and medication management. Conclusion: Primary care physicians valued the integrated pharmacy program highly, particularly its features of strong communication, expanded roles, and medication management. Pharmacists were viewed as integral members of the health care team.

Primary Care Providers Believe That Comprehensive Medication Management Improves Their Work-Life

“…For instance, physicians feel having a pharmacist in their clinic makes the physician more efficient, 24 -26 able to provide better care, 25,27 more knowledgeable, 25,27 more confident about prescribing, 26 more effective in treating challenging patients 26 and, in general, makes their job easier. 24 Despite ties to previous literature, the provider experience with CMM, as it relates to work-life, had not been defined.…”

Medicare Annual Wellness Visits: A Scoping Review of Current Practice Models and Opportunities for Pharmacists

“…Pharmacists embedded within the care team have the advantage of being able to communicate more frequently with the physician, either verbally or electronically, developing greater trust within the team that is often difficult to achieve when outsourced. 39,40 Further, this model allows the pharmacist-delivered service to be integrated into the site's workflow, with same-day co-visits being more convenient for both patients and physicians. 39 From the organizational perspective, the in-house model allows for greater degree of integration of the service to its core functions, which in turn increases its sustainability.…”

Clinical Pharmacists in Chronic Care

“…Their functions encompass comprehensive medication management (ie, prescribing, monitoring, and adjustment of medications), nonpharmacologic guidance, and coordination of care. Interdisciplinary collaboration allows pharmacists opportunities to provide direct patient care or consultations by telecommunication in many different clinical environments, including disease management, primary care, or specialty care [16][17][18][19]. Pharmacists may manage chronic or acute illnesses associated with endocrine, cardiovascular, respiratory, gastrointestinal, or other systems [20].Clinical pharmacist researchers generate, disseminate, and apply new knowledge that contributes to improve HRQoL [21][22][23][24].…”