"Pharming out" support: a promising approach to integrating clinical pharmacists into established primary care medical home practices

J Int Med Res. 2018 Jan;46(1):234-248. doi: 10.1177/0300060517710885. Epub 2017 Aug 8.

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.

Keywords: Collaborative drug therapy management; diabetes mellitus; hypertension; pharmacy; population health.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Ambulatory Care / organization & administration*
  • Antihypertensive Agents / therapeutic use
  • Biomarkers / blood
  • Diabetes Mellitus / diet therapy
  • Diabetes Mellitus / physiopathology
  • Disease Management
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Patient-Centered Care / organization & administration*
  • Pharmaceutical Services / organization & administration*
  • Pharmacists / organization & administration*
  • Workforce

Substances

  • Antihypertensive Agents
  • Biomarkers
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human