"Pharming out" support: a promising approach to integrating clinical pharmacists into established primary care medical home practices. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Brunisholz, Kimberly D.; Olson, Jeff; Anderson, Jonathan W.; Hays, Emily; Tilbury, Peggy M.; Winter, Bradley; Rickard, Josh; Hamilton, Sharon; Parkin, Gregory
• Is Part Of: Journal of international medical research. Volume 46:Issue 1(2018)
• Page Start: 234
• Page End: 248
• Publication Date: 2018-01
• Subjects: Collaborative drug therapy management -- pharmacy -- population health -- hypertension -- diabetes mellitus; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060517710885
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: Embedding clinical pharmacists into ambulatory care settings needs to be assessed in the context of established medical home models. Methods: A retrospective, observational study examined the effectiveness of the Intermountain Healthcare Collaborative Pharmacist Support Services (CPSS) program from 2012–2015 among adult patients diagnosed with diabetes mellitus (DM) and/or high blood pressure (HBP). Patients who attended this program were considered the intervention (CPSS) cohort. These patients were matched using propensity scores with a reference group (no-CPSS cohort) to determine the effect of achieving disease management goals and time to achievement. Results: A total of 17, 684 patients had an in-person office visit with their provider and 359 received CPSS (the matched no-CPSS cohort included 999 patients). CPSS patients were 93% more likely to achieve a blood pressure goal < 140/90 mmHg, 57% more likely to achieve HbA1c values < 8%, and 87% more likely to achieve both disease management goals compared with the reference group. Time to goal achievement demonstrated increasing separation between the study cohorts across the entire study period ( P < .001), and specifically, at 180 days post-intervention (HBP: 48% vs 27% P < .001 and DM: 39% vs 30%, P < .05). Conclusions: CPSS participation is associated with significant improvement in achievement of disease management goals, time to achievement, and increased ambulatory encounters compared with the matched no-CPSS cohort.