Development of a centralized, remote clinical pharmacy service to enhance primary care
More than 50% of Americans possess at least one chronic condition and another 25% suffer from two or more, leaving primary care teams tasked to care for the chronic, acute, and preventive care needs of their large patient panels. Pharmacists can reduce the burden on busy providers by effectively managing chronic diseases as members of health care teams. Many private physician practices lack the resources to include pharmacists on their teams. A centralized, remote clinical pharmacy services model allows pharmacists to remotely manage chronic disease in patients in collaboration with primary care providers. The purpose of this report is to describe how a centralized, remote clinical pharmacy team was developed, trained, and effectively integrated into multiple, diverse primary care settings across the U.S.
Boersma P, Black LI, Ward BW. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis. 2020;17:E106. https://doi.org/10.5888/pcd17.200130
Gerteis J, I.D., Deitz D, LeRoy L, et al. Multiple Chronic Conditions Chartbook. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/prevention-chronic-care/decision/mcc/mccchartbook.pdf (accessed Mar 2, 2021).
Yarnall KS, Østbye T, Krause KM, Pollak KI, Gradison M, Michener JL. Family physicians as team leaders: "time" to share the care. Prev Chronic Dis. 2009;6(2):A59.
Bodenheimer T, Chen E, Bennett HD. Confronting the growing burden of chronic disease: can the U.S. health care workforce do the job?. Health Aff (Millwood). 2009;28(1):64-74. https://doi.org/10.1377/hlthaff.28.1.64
Phillips JP, Wendling A, Bentley A, Marsee R, Morley CP. Trends in US Medical School Contributions to the Family Physician Workforce: 2018 Update From the American Academy of Family Physicians. Fam Med. 2019;51(3):241-250. https://doi.org/10.22454/fammed.2019.395617
Hwang AY, Gums TH, Gums JG. The benefits of physician-pharmacist collaboration. J Fam Pract. 2017;66(12):E1-E8.
Borenstein JE, Graber G, Saltiel E, et al. Physician-pharmacist comanagement of hypertension: a randomized, comparative trial. Pharmacotherapy. 2003;23(2):209-216. https://doi.org/10.1592/phco.184.108.40.206096
Carter BL, Coffey CS, Ardery G, et al. Cluster-randomized trial of a physician/pharmacist collaborative model to improve blood pressure control. Circ Cardiovasc Qual Outcomes. 2015;8(3):235-243. https://doi.org/10.1161/circoutcomes.114.001283
Hunt JS, Siemienczuk J, Pape G, et al. A randomized controlled trial of team-based care: impact of physician-pharmacist collaboration on uncontrolled hypertension. J Gen Intern Med. 2008;23(12):1966-1972. https://doi.org/10.1007/s11606-008-0791-x
Schottenfeld L, Petersen D, Peikes D, et al. Creating patient-centered team-based primary care. https://pcmh.ahrq.gov/sites/default/files/attachments/creating-patient-centered-team-based-primary-care-white-paper.pdf (accessed Mar 2, 2021).
Green BB, Cook AJ, Ralston JD, et al. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA. 2008;299(24):2857-2867. https://doi.org/10.1001/jama.299.24.2857
Merenich JA, Olson KL, Delate T, et al. Mortality reduction benefits of a comprehensive cardiac care program for patients with occlusive coronary artery disease. Pharmacotherapy. 2007;27(10):1370-1378. https://doi.org/10.1592/phco.27.10.1370
Witt DM, Sadler MA, Shanahan RL, Mazzoli G, Tillman DJ. Effect of a centralized clinical pharmacy anticoagulation service on the outcomes of anticoagulation therapy. Chest. 2005;127(5):1515-1522. https://doi.org/10.1378/chest.127.5.1515
Sandhoff BG, Nies LK, Olson KL, Nash JD, Rasmussen JR, Merenich JA. Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization. Am J Health Syst Pharm. 2007;64(1):77-84. https://doi.org/10.2146/ajhp060022
Carter BL, Levy BT, Gryzlak B, et al. A centralized cardiovascular risk service to improve guideline adherence in private primary care offices. Contemp Clin Trials. 2015;43:25-32. https://doi.org/10.1016/j.cct.2015.04.014
Carter BL, Coffey CS, Chrischilles EA, et al. A Cluster-Randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence. Pharmacotherapy. 2015;35(7):653-662. https://doi.org/10.1002/phar.1603
Martin R, Tram K, Le L, Simmons C. Financial performance and reimbursement of pharmacist-led chronic care management. Am J Health Syst Pharm. 2020;77(23):1973-1979. https://doi.org/10.1093/ajhp/zxaa300
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