Scientific Poster Session II - Late Breaking Original Research

Late Breaking Original Research
  Sunday, October 13, 2024
  12:45 PM–02:15 PM

Abstract

Introduction: Comprehensive medication management (CMM) in primary care settings can improve patient outcomes and decrease costs for preventable hospitalizations and ER visits. Also, reports indicate CMM can decrease primary care physician (PCP) workload and promote professional satisfaction. Yet, there is little quantifiable data on the impact of embedded pharmacists in primary care teams to offset PCP clinical workload burden and expand patient access to PCP appointments.

Research Question or Hypothesis: Embedded pharmacist CMM services can reduce PCP clinical workload burden and improve patient access.

Study Design: Mixed-methods study at a health-system ACO; one embedded pharmacist was shared across 3 practices with 29 PCPs.

Methods: The embedded pharmacist met with PCP-referred patients by appointment and had collaborative practice agreements (CPAs) with PCPs for multiple chronic conditions. The pharmacist used CMM practice processes and met with patients until their therapy goals were achieved.

Data inputs: onsite workflow mapping using workload calculations verified with administrative/clinical leaders. Qualitative data was collected in an ACO leaders survey.

Endpoints: (1) pharmacist workload capacity for CMM patients/year, (2) PCP clinical workload reduction with CMM services, (3) additional PCP appointments opened up to improve patient access.

Results:

Capacity: Embedded pharmacist can manage a panel of 640 patients/year for longitudinal CMM visits until patients’ drug therapy goals are achieved (usually 4 patient-visits per year).

PCP Clinical Workload: Approximate reduction by 640-850 hours/year with embedded pharmacist using a CPA to implement drug therapy changes/monitoring without requiring PCP review/approval.

Patient Access: Pharmacist-provided CMM services can open up 1,920 PCP-patient appointments/year.

ACO Leader Survey: Embedded pharmacist CMM services informed strategic and operational planning, payer negotiations.

Conclusion: PCP clinical workload burden can be reduced when an embedded pharmacist provides CMM services using CPAs with primary care teams. Patient access can be expanded by opening up PCP appointments when patients with medication optimization and management needs are referred to the embedded pharmacist.

Presenting Author

Marie Smith PharmD, FNAP
University of Connecticut

Authors

Mary Mulrooney PharmD, MBA
University of Connecticut