Improving population management through pharmacist-primary care integration: a pilot study.

Area of Science:

• Health Services Research
• Clinical Pharmacy Practice
• Primary Care Medicine

Background:

• Pharmacists possess unique skills applicable to primary care settings.
• Patient-centered medical homes (PCMHs) aim to improve care coordination and patient outcomes.
• Population management is a key component of modern primary care.

Purpose of the Study:

• To evaluate the impact of integrating pharmacists into PCMHs.
• To assess the role of pharmacists in population-based medication management and prescriber education.
• To determine the cost-effectiveness of pharmacist integration in primary care.

Main Methods:

• A demonstration project partnered pharmacists with 5 primary care practices in Vermont.
• Pharmacists provided direct patient care, population-based medication management, and prescriber education one day per week.
• Data collected included drug therapy problems identified and cost avoidance models.

Main Results:

• Pharmacists identified 708 drug therapy problems (DTPs), with 47.5% from direct care, 38.9% from population strategies, and 13.6% from education.
• Prescribers accepted 86% of pharmacist recommendations for DTPs.
• A cost avoidance model indicated $2.11 in savings for every $1.00 spent on pharmacist services.

Conclusions:

• Integrating pharmacists into primary care teams provides significant value, preventing adverse drug events and reducing costs.
• Pharmacists are well-suited for direct patient care, population management, and prescriber education within PCMHs.
• Successful integration requires electronic health record access and exploration of alternative funding models beyond fee-for-service.