Implementation of a community-based pharmacist-run attention deficit hyperactivity disorder clinic in a college...

Published evidence is lacking to describe the pharmacist's role in medication management within an attention deficit hyperactivity disorder (ADHD) specialty clinic.

The objectives were (1) to measure the growth of an ADHD clinic in a college health center after the integration of clinical pharmacists and (2) to evaluate provider adherence to clinic policies and procedures before and after pharmacist integration.

In 2017, a pharmacist-run ADHD clinic was established at a college campus.

Pharmacists conducted collaborative initial visits with psychiatrists and independently provided follow-up appointments for patients with ADHD.

Data were extracted from the electronic health record for patients aged 18 years or older with an ADHD diagnosis who completed a medication evaluation or medication follow-up visit from July 1, 2016 to June 30, 2019. Data were excluded if it was for another visit type, was a non-ADHD clinic provider visit, or if the visit note was classified. Data before the pharmacist integration (July 1, 2016-June 30, 2017) were compared with data after the pharmacist integration (July 1, 2017-June 30, 2019). Chi-square tests of independence evaluated differences in blood pressure monitoring, heart rate monitoring, and stimulant medication contract signature between psychiatrist- and pharmacist-run appointments.

Pharmacist presence in the ADHD clinic increased from 0 full-time equivalent (FTE) to 0.2 FTE over 3 years. The number of appointments increased by 1003% (from 26 to 287). Compared with psychiatrist-run appointments, pharmacist-run appointments were more adherent to monitoring blood pressure (11% vs. 77%, P < 0.001) and heart rate (6% vs. 75%, P < 0.001), as well as clinic policy requiring a patient's signature on a stimulant medication contract (64% vs. 75%, P = 0.019).

Pharmacists can assist psychiatrists in medication management of ADHD in the college health setting. A pharmacist-psychiatrist collaboration increased quality of care and monitoring of medication adverse effects.