Pharmacist time requirements for counseling in an outpatient pharmacy

The correlation between the pharmacist time required for counseling patients and the characteristics of the services provided was studied. Data from the Kaiser Permanente/USC Patient Consultation Study were used to examine the relationship between pharmacist time and potential problems, actions to resolve the problems, and disposition of prescriptions. A regression model was estimated with pharmacist time as the dependent variable. An encounter consisting of patient contact to monitor adverse effects, duplicate therapy, or compliance took an estimated three minutes on average. Problems related to appropriateness of therapy or drug interactions required an additional 1.8 and 0.5 minutes, respectively. Four additional minutes were required for provider contact unless the contact involved a simple clarification (an additional 2.6 minutes). Patient referrals required an additional 2.5 minutes. The time requirements related to the problem addressed and action taken were not additive. The incremental time requirements across alternative problem-action clusters ranged from 2.9 to 9 minutes. A fee-for-service payment system appears to be feasible for pharmacist counseling services.