Access to clinical pharmacy services in a pharmacist-physician covisit model.


Journal

Research in social & administrative pharmacy : RSAP
ISSN: 1934-8150
Titre abrégé: Res Social Adm Pharm
Pays: United States
ID NLM: 101231974

Informations de publication

Date de publication:
07 2021
Historique:
received: 24 06 2020
revised: 28 09 2020
accepted: 05 10 2020
pubmed: 7 11 2020
medline: 3 8 2021
entrez: 6 11 2020
Statut: ppublish

Résumé

A pharmacist-physician covisit model in which patients see both a pharmacist and physician on the same day was established in a primary care practice. Previously, patients were seen in a referrals-based model in which providers referred patients for clinical pharmacy services on a different day. To assess access to clinical pharmacy services in a pharmacist-physician covisit model compared to a referrals-based model. A retrospective chart review was completed for patients who were seen by physicians on pre-specified half-days of clinic before and after implementation of the covisit model. Covisit model half-days between June 29, 2018 and September 30, 2018 and matched half-days from 2015 were included. Charts were reviewed to determine if patients scheduled to see the physician would benefit from clinical pharmacy services, including being seen for chronic disease management, eligible for a Medicare Annual Wellness Visit (AWV), prescribed medications that required counseling, had an adverse medication-related event, or had adherence concerns. Those eligible for clinical pharmacy services were further reviewed to determine if the patient interacted with a pharmacist within three months of their visit. Prior to implementation of the covisit model, 123 patient visits were completed on the pre-specified half-days. Of these, 61 patients (49.6%) were deemed eligible for clinical pharmacy services. In the covisit model, 149 patients were seen by the physician, of which 69 patients (46%) were eligible for clinical pharmacy services. More patients in the covisit cohort went on to interact with a pharmacist (56 patients, 81% vs. 10 patients, 16%, adjusted OR = 32.98, 95% CI [8.89-122.39]). The most common reasons patients were identified for clinical pharmacy services were eligibility for AWV, hypertension, and diabetes. A pharmacist-physician covisit model significantly increased accessibility to clinical pharmacy services compared to a referrals-based model.

Sections du résumé

BACKGROUND
A pharmacist-physician covisit model in which patients see both a pharmacist and physician on the same day was established in a primary care practice. Previously, patients were seen in a referrals-based model in which providers referred patients for clinical pharmacy services on a different day.
OBJECTIVE
To assess access to clinical pharmacy services in a pharmacist-physician covisit model compared to a referrals-based model.
METHODS
A retrospective chart review was completed for patients who were seen by physicians on pre-specified half-days of clinic before and after implementation of the covisit model. Covisit model half-days between June 29, 2018 and September 30, 2018 and matched half-days from 2015 were included. Charts were reviewed to determine if patients scheduled to see the physician would benefit from clinical pharmacy services, including being seen for chronic disease management, eligible for a Medicare Annual Wellness Visit (AWV), prescribed medications that required counseling, had an adverse medication-related event, or had adherence concerns. Those eligible for clinical pharmacy services were further reviewed to determine if the patient interacted with a pharmacist within three months of their visit.
RESULTS
Prior to implementation of the covisit model, 123 patient visits were completed on the pre-specified half-days. Of these, 61 patients (49.6%) were deemed eligible for clinical pharmacy services. In the covisit model, 149 patients were seen by the physician, of which 69 patients (46%) were eligible for clinical pharmacy services. More patients in the covisit cohort went on to interact with a pharmacist (56 patients, 81% vs. 10 patients, 16%, adjusted OR = 32.98, 95% CI [8.89-122.39]). The most common reasons patients were identified for clinical pharmacy services were eligibility for AWV, hypertension, and diabetes.
CONCLUSIONS
A pharmacist-physician covisit model significantly increased accessibility to clinical pharmacy services compared to a referrals-based model.

Identifiants

pubmed: 33153913
pii: S1551-7411(20)31119-0
doi: 10.1016/j.sapharm.2020.10.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1321-1326

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Irene Park Ulrich (IP)

Mountain Area Health Education Center; UNC Eshelman School of Pharmacy; UNC School of Medicine; 123 Hendersonville Road, Asheville, NC, 28803, USA. Electronic address: Irene.Ulrich@mahec.net.

Brunilda Lugo (B)

UNC Health Sciences at the Mountain Area Health Education Center, USA. Electronic address: Brunilda.Lugo@mahec.net.

Phillip Hughes (P)

UNC Health Sciences at the Mountain Area Health Education Center, USA. Electronic address: phillip.hughes@mahec.net.

Lorna Doucette (L)

UNC Eshelman School of Pharmacy, UNC Gillings School of Global Public Health, USA. Electronic address: Lornado@email.unc.edu.

Bianca B Creith (BB)

UNC Eshelman School of Pharmacy, USA. Electronic address: Bianca.Creith@va.gov.

Sean Flanagan (S)

UNC Eshelman School of Pharmacy, USA. Electronic address: Sean_Flanagan@unc.edu.

Benjamin Gilmer (B)

Family Medicine Faculty Physician, Mountain Area Health Education Center, UNC School of Medicine, USA. Electronic address: Benjamin.Gilmer@mahec.net.

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Classifications MeSH