Describing pharmacist services provided to clinic patients outside of accredited patient management program responsibilities in a health-system specialty pharmacy.

PURPOSE: Describe clinical pharmacist services provided for clinic patients not actively enrolled in an integrated health-system specialty pharmacy (HSSP) patient management program or with medications fulfilled externally.

METHODS

Single-center, quality improvement project evaluating pharmacist actions and interventions, as a result of provider, nurse, or patient requests for pharmacy services, for patients not enrolled in the integrated HSSP. Eighteen clinical pharmacists, covering nine different clinics (oncology and non-oncology), documented medication therapy problem (MTP) and drug information (DI) question type, average workload, and time spent for request completion between September-November 2023. Data are reported descriptively.

RESULTS

Clinical pharmacists documented 775 requests involving 630 patients and resulting in 926 actions. MTPs accounted for 26% and DI questions for 74% of all pharmacist actions. Most MTPs were related to adverse medication events/toxicity (40%) and cost (34%) and DI questions to drug-drug interactions (22%) and care coordination (20%). In oncology clinics, most requests involved non-specialty medications (50%) and infusions (32%) and were initiated by providers. In non-oncology clinics, most requests involved specialty medications fulfilled externally (62%) and were initiated by patients. On average, 43 requests and 51 actions were managed per pharmacist over the project period. Most were completed in < 15 minutes (71%).

CONCLUSION

This project highlights clinical pharmacist contributions to non-enrolled patients alongside responsibilities within the scope of traditional specialty pharmacy-accredited patient management programs. These findings show minimal additional workload, however, should continue to be evaluated as HSSP enrollment grows, clinic patient numbers expand, and interest in managing complex chronic conditions are explored.