Implementation of a Pilot Pharmacist Testosterone Therapy Management Service

Area of Science:

• Endocrinology
• Pharmacology
• Primary Care Medicine

Background:

• Optimization of testosterone replacement therapy (TRT) management is an area of recent focus.
• Existing literature suggests potential improvements in TRT protocols.

Purpose of the Study:

• To assess the impact of a clinical pharmacist-led TRT management service.
• The service was piloted within a Veterans Affairs primary care setting.

Main Methods:

• A 6-month prospective cohort quality improvement project was conducted.
• Male patients with active testosterone prescriptions were included, with specific exclusion criteria.
• Primary care providers could refer patients for pharmacist management.

Main Results:

• Pharmacist management significantly improved baseline parameter monitoring (54% vs. 20%, P=0.0006).
• Therapeutic monitoring for symptom improvement (96% vs. 26%, P<0.001) and testosterone levels (96% vs. 61%, P=0.003) increased.
• Pharmacist interventions saved over 600 minutes of primary care provider time.

Conclusions:

• Clinical pharmacist involvement enhances therapeutic monitoring in male hypogonadism.
• There is potential for expanding clinical pharmacy services in TRT management.