Pharmacist eConsult service for primary care medication optimization and safety

Area of Science:

• Pharmacotherapy
• Primary Care Medicine
• Health Informatics

Background:

• Primary care lacks clinical pharmacists, hindering medication outcome management.
• eConsult services offer a solution for primary care providers (PCPs) to access pharmacotherapy specialists.
• Integrating clinical pharmacists into eConsult networks addresses a critical gap in medication management.

Purpose of the Study:

• To assess the utilization of clinical pharmacists within an established eConsult network.
• To characterize the types and usage patterns of pharmacist eConsults initiated by PCPs.
• To measure the rate of implementation of pharmacist recommendations by PCPs.

Main Methods:

• A federally qualified health center implemented a pharmacist eConsult service via an existing platform.
• A clinical pharmacist responded to eConsults within two business days.
• PCPs received training on the service, including suitable topics and workflow.

Main Results:

• 57 eConsults with 123 questions were addressed; Advanced Practice Registered Nurses (APRNs) submitted significantly more eConsults than physicians.
• APRNs' queries focused on adverse drug events and dosage adjustments, while physicians sought medication regimen reviews and patient-specific adjustments.
• PCPs implemented at least 50% of pharmacist recommendations in 74% of responses.

Conclusions:

• Pharmacist eConsults are a viable service for addressing medication-related questions in primary care.
• This model can enhance prescribing quality and safety, particularly for chronic medication management.
• Integrating pharmacists into eConsult networks supports value-based care initiatives.