American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2011
Impact of health disparities on staff workload in pharmacist-managed anticoagulation clinics.
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Meade Michele, Borchert Jill, Griffin Brooke, Kliethermes Mary Ann, Komperda Kathy
Аннотация
PURPOSE: Pharmacists' provision of services unrelated to anticoagulant therapy at an anticoagulation clinic in an area of prevalent health disparities (health status differences between minority and nonminority populations) was evaluated.
SUMMARY: A prospective cohort study was conducted to compare the frequency and types of additional services (i.e., services unrelated to anticoagulation) provided by pharmacists during an eight-week period at an urban clinic serving a primarily minority and socioeconomically disadvantaged patient population (clinic A) and a suburban clinic serving a primarily nonminority and affluent population (clinic B). Over the study period, additional services were provided during 42% of all patient visits (n = 444) at clinic A and 8% of all visits (n = 443) at clinic B. The most commonly provided additional services involved nonanticoagulation-related medical problems, which were addressed during about 9% of visits at clinic A and 3% of visits at clinic B; other additional services included setting up appointments, arranging transportation, and providing refills of nonanticoagulant medications. Missed appointments, early or late arrivals, and walk-in appointments were much more common at clinic A. The average daily pharmacist-staffing requirement was 3.8 hours higher at clinic A; over the entire study period, clinic A required a total of about 60 more staffed hours than clinic B.
CONCLUSION: Pharmacists practicing in an anticoagulation clinic serving an area of prevalent health disparities frequently spent a substantial amount of time addressing medical problems and administrative tasks unrelated to anticoagulation therapy.
SUMMARY: A prospective cohort study was conducted to compare the frequency and types of additional services (i.e., services unrelated to anticoagulation) provided by pharmacists during an eight-week period at an urban clinic serving a primarily minority and socioeconomically disadvantaged patient population (clinic A) and a suburban clinic serving a primarily nonminority and affluent population (clinic B). Over the study period, additional services were provided during 42% of all patient visits (n = 444) at clinic A and 8% of all visits (n = 443) at clinic B. The most commonly provided additional services involved nonanticoagulation-related medical problems, which were addressed during about 9% of visits at clinic A and 3% of visits at clinic B; other additional services included setting up appointments, arranging transportation, and providing refills of nonanticoagulant medications. Missed appointments, early or late arrivals, and walk-in appointments were much more common at clinic A. The average daily pharmacist-staffing requirement was 3.8 hours higher at clinic A; over the entire study period, clinic A required a total of about 60 more staffed hours than clinic B.
CONCLUSION: Pharmacists practicing in an anticoagulation clinic serving an area of prevalent health disparities frequently spent a substantial amount of time addressing medical problems and administrative tasks unrelated to anticoagulation therapy.