Scientific Poster Session III - Clinical Pharmacy Forum

Clinical Pharmacy Forum
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Service or Program: Recent guideline changes recommend the use SMART with a single combination inhaler of an inhaled corticosteroid and formoterol in patients with moderate to severe asthma to decrease exacerbations. The clinical pharmacy specialists in the Primary Care Medicine Clinic (PCMC) at Barnes-Jewish Hospital developed educational resources and screening tools to implement updates. Handouts were created and distributed to physicians detailing changes and how to properly order SMART therapy. Patients with active albuterol prescriptions and scheduled for appointments in the upcoming week were screened through reports generated by the electronic medical record (EMR). Patient’s inhaler refill history, insurance, and hospitalizations were reviewed. Patients with Medicaid and one or more hospitalizations due to asthma in the past year or uncontrolled on current inhalers as evidenced by albuterol refills of 3 or more in a 6-month period were selected for evaluation.

Justification/Documentation: Overuse of short acting beta agonists (SABA) is a risk factor for poor asthma control and severe exacerbations. Messages were sent to physicians detailing a patient's course of condition and recommendations for implementation of SMART. If SMART was prescribed, the PCMC Pharmacy team would educate the patient at the upcoming visit. The pharmacists were able to follow up with education and implementation timely by targeting patients with upcoming appointments.

Adaptability: Pharmacists and pharmacy students were involved in screening patients. This process may be applied to any outpatient setting with EMR reporting tools and could be modified to fit any guideline directed change.

Significance: Approximately 80 patients were screened between June and July 2022 and 20 patients were identified as candidates for change. This highlights the impact clinical pharmacists can have on implementing guideline therapy on a large number of patients in a short time period. Including learners in the process provided an opportunity for a greater impact than would be seen with traditional chart review.

Presenting Author

Rachel Howland PharmD, BCPS
Barnes Jewish Hospital

Authors

Christine Kelso Pharm.D., BCPS, AE-C
Barnes-Jewish Hospital

Sue Lee-Chuu PharmD, BCPS
Barnes Jewish Hospital

Thomas Hundley Student Pharmacist
St Louis College of Pharmacy