Advancing Pharmacist Collaborative Care within Academic Health Systems (original) (raw)

Physician experiences with clinical pharmacists in primary care teams

Journal of the American Pharmacists Association : JAPhA, 2017

Improving medication management is an important component of comprehensive care coordination for health systems. The Managing Your Medication for Education and Daily Support (MyMeds) medication management program at the University of California Los Angeles addresses medication management issues by embedding trained clinical pharmacists in primary care practice teams. The aim of this work was to examine and explore physician opinions about the clinical pharmacist program and identify common themes among physician experiences as well as barriers to integration of clinical pharmacists into primary care practice teams. We conducted a mixed quantitative-qualitative methods study consisting of a cross-sectional physician survey (n = 69) as well as semistructured one-on-one physician interviews (n = 13). Descriptive statistics were used to summarize survey responses, and standard qualitative content-analysis methods were used to identify major themes from the interviews. The survey respons...

The Role of Pharmacy Through Collaborative Practice in an Ambulatory Care Clinic

American Journal of Lifestyle Medicine, 2017

Pharmacists have been practicing in ambulatory care environments managing patients with chronic illnesses since the 1970s. The US Surgeon General and the Centers for Disease Control and Prevention support pharmacists working in collaboration with physicians to optimize medication outcomes, improve patient satisfaction, and lower health care costs. Through collaborative practice agreements, pharmacists are able to work as part of a health care team with access to electronic health records, and they assist busy physicians manage patients with chronic diseases such as diabetes. This article will review the different types of ambulatory care practice settings, what is included in a collaborative practice agreement, the credentialing and privileging of pharmacists working in such environments, the qualifications of pharmacists, the scope of practice, and some challenges for reimbursement.

Pharmacists as Interprofessional Collaborators and Leaders through Clinical Pathways

Pharmacy (Basel, Switzerland), 2018

Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets. Fifteen CPs leading to admissions in medical wards were developed and integrated into Computerized Prescriber Order Entry (CPOE) sets. Tools and services included (1) reporting of creatinine clearance to guide optimum dosing; (2) advisory flags for dosing and infusion rates; (3) piloting of medication reconciliation and counseling services before discharge were initiated; (4) Arab...

Collaborative drug therapy management by pharmacists. American College of Clinical Pharmacy

Pharmacotherapy, 1997

The traditional system of providing drug therapy to patients, in which only certain health care professionals are authorized to initiate drug therapy, is under attack at many levels. The processes of drug prescribing, dispensing, administration, monitoring,’ and dosage adjustment, as practiced in this traditional system, occur in a disjointed fashion. that frequently results in avoidable drug-related problems that contribute significantly to poor patient outcomes and increased medical costs.’ Collaborative drug therapy management, characterized by an interdisciplinary approach to patient care, is emerging as a solution that can maximize the patient’s health-related quality of life, reduce the frequency of avoidable drugrelated problems, and improve societal benefits from pharmaceuticals. In this approach to care, drug therapy decision making and management are coordinated collaboratively by pharmacists, physicians, other health care professionals, and the patient. Many pharmacists w...

US Pharmacists' Effect as Team Members on Patient Care

Medical Care, 2010

Background: One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists. Objective: The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes. Methods: The following databases were searched from inception to January 2009: NLM PubMed; Ovid/MEDLINE; ABI/IN-FORM; Health Business Fulltext Elite; Academic Search Complete; International Pharmaceutical Abstracts; PsycINFO; Cochrane Database of Systematic Reviews; National Guideline Clearinghouse; Database of Abstracts of Reviews of Effects; ClinicalTrials.gov; LexisNexis Academic Universe; and Google Scholar. Studies selected included those reporting pharmacistprovided care, comparison groups, and patient-related outcomes. Of these, 56,573 citations were considered. Data were extracted by multidisciplinary study review teams. Variables examined included study characteristics, pharmacists' interventions/services, patient characteristics, and study outcomes. Data for meta-analyses were extracted from randomized controlled trials meeting meta-analysis criteria. Results: A total of 298 studies were included. Favorable results were found in therapeutic and safety outcomes, and meta-analyses conducted for hemoglobin A1c, LDL cholesterol, blood pressure, and adverse drug events were significant (P Ͻ 0.05), favoring pharmacists' direct patient care over comparative services. Results for humanistic outcomes were favorable with variability. Medication adherence, patient knowledge, and quality of life-general health meta-analyses were significant (P Ͻ 0.05), favoring pharmacists' direct patient care. Conclusions: Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve US health care.