Ambulatory Care Pharmacy Services: Has the Agenda Changed?

2000 ◽  
Vol 34 (6) ◽  
pp. 772-787 ◽  
Author(s):  
Barry L Carter ◽  
Dennis K Helling
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Managed Care ◽  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Relevant Literature ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
Care Family ◽  
Veterans Affairs Medical Centers

OBJECTIVE: To provide an extensive review of ambulatory care clinical pharmacy services and evaluate the services and research data in the field. DATA SOURCES: MEDLINE was searched from January 1992 through July 1999. Search terms included pharmacy, clinical pharmacy, and pharmaceutical care, cross-referenced with ambulatory care, primary care, family medicine, and managed care. STUDY SELECTION: Relevant peer-reviewed studies and reports since our previous article in 1992 were selected and described. Literature prior to 1992 was briefly reviewed. DATA SYNTHESIS: The relevant literature was reviewed and some examples from the authors' institutions are provided. Much research has continued to be published documenting the value of clinical pharmacy services in ambulatory care, including in community pharmacy, anticoagulation services, family medicine, primary care clinics, Veterans Affairs Medical Centers, and managed care. However, these innovative services are underrepresented in the community at large. The vast majority of the public does not have access to these types of services. CONCLUSIONS: There will be continued and dramatic expansion of ambulatory care pharmacy services in the new decade beginning in the year 2000. It will be critical that standards of practice be very high. We believe there is a critical need for visible demonstration projects and large multicenter research projects that demonstrate the value of these services.

Establishing Clinical Pharmacy Services With Prescribing Privileges in a Federally Qualified Health Center Primary Care Clinic

2017 ◽  
Vol 31 (5) ◽  
pp. 434-440 ◽  
Author(s):  
Jeany K. Jun
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Clinical Pharmacy ◽  
Primary Care Clinic ◽  
Pharmacy Services ◽  
Care Clinic ◽  
Clinical Pharmacy Services ◽  
Clinical Pharmacists ◽  
Federally Qualified Health Center ◽  
Ambulatory Patients

Objectives: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. Setting: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician. Practice Innovation: New clinical pharmacy services were established at this FQHC primary care clinic. The medication assistance program was a stepping stone to establish rapport with the physicians. Credentialing and privileging was implemented for clinical pharmacists. An open protocol collaborative practice agreement was developed to allow clinical pharmacists to manage ambulatory patients. Results: From August 2014 to June 2015, the clinical pharmacist interacted with 392 patients and spent 336 hours educating patients and providing disease state management. The pharmacist also provided consults to residents and providers. Diabetic patients made up 76% of all clinical pharmacy encounters. There were 86 face-to-face clinical pharmacy appointments with the pharmacist. The average time for clinical pharmacy appointments was 77 minutes. Conclusion: By describing ways to develop rapport with providers, how to credential and privilege pharmacists, and explain resources and costs of setting up a service, the hope is that more clinical pharmacists will be able to incorporate into independent or FQHC primary care clinics for improved management of ambulatory patients.

Primary care pharmacy technicians: Effect on pharmacist workload and patient access to clinical pharmacy services

2020 ◽  
Vol 77 (Supplement_4) ◽  
pp. S93-S99
Author(s):  
Dmitry Walker ◽  
Katherine J Hartkopf ◽  
David R Hager
Keyword(s):  
Primary Care ◽  
Clinical Pharmacy ◽  
Relative Increase ◽  
Relative Reduction ◽  
Pharmacy Services ◽  
Patient Access ◽  
Pharmacy Technician ◽  
Work Sampling ◽  
Clinical Pharmacy Services ◽  
Pharmacy Technicians

Abstract Purpose Improve patient access to clinical pharmacy services and decrease pharmacist technical task workload in primary care (PC) clinics. Summary Due to concerns with the amount of technical tasks performed by University of Wisconsin Health PC clinical pharmacists negatively impacting their capacity to care for patients and perform clinical tasks, the pharmacy department piloted a new PC pharmacy technician role that involved completion of technical tasks previously performed by PC pharmacists. PC pharmacist daily technical and clinical activities were identified through shadowing and quantified by a 4-week period of work sampling. A PC pharmacist workgroup determined the technical tasks that would be appropriate for a pharmacy technician to complete and developed the technician workflows. A PC pharmacy technician was implemented during a 3-week pilot, when pharmacist daily technical and clinical activities were quantified through work sampling. Following implementation, a 52.7% (P < 0.001) relative reduction and a 10.2% (P < 0.001) relative increase in pharmacist technical and clinical activities, respectively, were identified. Additionally, a 10% relative increase from the previous 3-month average was observed in the PC pharmacist rolling patient panel size during the pilot period, correlating with an increase of patient access to pharmacist clinical services. Conclusion Up to 17% of PC pharmacist daily activities are technical tasks. Leveraging pharmacy technicians to support pharmacists with completion of these tasks increases patient access to clinical pharmacy services but requires additional staff resources.

scholarly journals Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease

2016 ◽  
Vol 33 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Amber Lanae Smith ◽  
Valerie Palmer ◽  
Nada Farhat ◽  
James S. Kalus ◽  
Krishna Thavarajah ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Ambulatory Care ◽  
Pulmonary Disease ◽  
Clinical Pharmacy ◽  
Chronic Obstructive ◽  
Pharmacy Services ◽  
Obstructive Pulmonary Disease ◽  
Clinical Pharmacy Services ◽  
Significant Difference ◽  
The Impact

Background: No systematic evaluations of a comprehensive clinical pharmacy process measures currently exist to determine an optimal ambulatory care collaboration model for chronic obstructive pulmonary disease (COPD) patients. Objective: Describe the impact of a pharmacist-provided clinical COPD bundle on the management of COPD in a hospital-based ambulatory care clinic. Methods: This retrospective cohort analysis evaluated patients with COPD managed in an outpatient pulmonary clinic. The primary objective of this study was to assess the completion of 4 metrics known to improve the management of COPD: (1) medication therapy management, (2) quality measures including smoking cessation and vaccines, (3) patient adherence, and (4) patient education. The secondary objective was to evaluate the impact of the clinical COPD bundle on clinical and economic outcomes at 30 and 90 days post–initial visit. Results: A total of 138 patients were included in the study; 70 patients served as controls and 68 patients received the COPD bundle from the clinical pharmacist. No patients from the control group had all 4 metrics completed as documented, compared to 66 of the COPD bundle group ( P < .0001). Additionally, a statistically significant difference was found in all 4 metrics when evaluated individually. Clinical pharmacy services reduced the number of phone call consults at 90 days ( P = .04) but did not have a statistically significant impact on any additional pre-identified clinical outcomes. Conclusion: A pharmacist-driven clinical COPD bundle was associated with significant increases in the completion and documentation of 4 metrics known to improve the outpatient management of COPD.

scholarly journals Establishing a New Ambulatory Care Practice Site as a Pharmacy Practice Faculty

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 111 ◽  
Author(s):  
Vasudha Gupta ◽  
Evan Williams
Keyword(s):  
Ambulatory Care ◽  
Clinical Pharmacy ◽  
Clinical Skills ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Pharmacy Services ◽  
Clinical Faculty ◽  
Clinical Pharmacy Services ◽  
Clear Vision ◽  
Pharmacist Services

There is an imminent need to identify and develop new ambulatory care practice sites with the increase in the number of colleges of pharmacy across the nation. This manuscript provides recommendations to help clinical faculty determine whether a potential pharmacy practice site will be able to provide adequate resources and support to establish a successful practice. This may be challenging to pharmacy practice faculty in settings where clinical pharmacy services have never been utilized. Topics include the pre-work needed prior to approaching a new practice site, assessing the need for physical requirements, meeting key personnel, marketing clinical skills and services, implementing, and evaluating practice site. Preparation includes having a clear vision of the pharmacist services, ensuring that stakeholders have an understanding of the pharmacy services inquiring the site support and resources for the pharmacist, and regularly communicating.

Ambulatory Care Pharmacy Services: The Incomplete Agenda

1992 ◽  
Vol 26 (5) ◽  
pp. 701-708 ◽  
Author(s):  
Barry L. Carter ◽  
Dennis K. Helling
Keyword(s):  
Ambulatory Care ◽  
Patient Outcomes ◽  
Clinical Pharmacy ◽  
English Language ◽  
Data Extraction ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
Standards Of Practice ◽  
Study Selection ◽  
The Impact

OBJECTIVE: To review studies that document the impact of clinical pharmacy services in ambulatory care settings and to propose standards of practice and resource allocation needs in ambulatory care. DATA SOURCES: English-language literature from 1970 through 1991 was reviewed and the representative literature is described. STUDY SELECTION: Studies were selected that examined the impact of clinical pharmacy services on patient outcomes and costs. Studies that evaluated pharmacist consultations by blind peer-review panels were also evaluated. DATA EXTRACTION: Trials were assessed based on their methodologies and ability to assess the value of clinical pharmacy services on patient outcomes. DATA SYNTHESIS: Numerous studies from the past 20 years are described illustrating the impact that ambulatory care pharmacy practitioners have made on patient care. These studies demonstrate that clinical pharmacists in ambulatory care not only serve as consultants on pharmacotherapy issues, but also can improve the quality of care for individual patients. CONCLUSIONS: Based on the studies cited and the needs of ambulatory patients, this article highlights the authors' views on what the standards of practice should be for ambulatory care practitioners and where resources should be allocated as ambulatory programs are expanded.

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