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Clinical Pharmacist Integration Into Veterans' Primary Care: Team Members Perspectives.

Anna Zogas1, Chris Gillespie1, Felicia Kleinberg1

  • 1From the Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, MA (AZ); Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, MA (CG, FK, JIR, NN, DRM, MBM); Pharmacy Benefits Management Services, National Clinical Pharmacy Practice Office, US Department of Veterans Affairs, Washington, DC (MHT, HLO, APM); University of Massachusetts, Lowell, Center for Population Health (DRM); University of Massachusetts, Lowell, Zuckerberg School of Health Sciences, Department of Public Health (MBM).

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Summary

Integrating Clinical Pharmacy Specialists (CPS) into patient-centered medical homes (PCMH) can occur in consultative or collaborative roles. Collaborative integration allows CPS to optimize patient care by managing disease states comprehensively.

Keywords:
Clinical PharmacistsDisease ManagementInterprofessional RelationsMedical HomeMedication Therapy ManagementMilitary MedicinePatient Care TeamPharmacistsPrimary Care PhysiciansPrimary Health CareQualitative ResearchVeterans Health

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Area of Science:

  • Health Services Research
  • Interprofessional Team Dynamics
  • Primary Care Practice Transformation

Background:

  • Patient-centered medical homes (PCMH) involve primary care team restructuring.
  • Limited research exists on integrating extended team members into established PCMH.
  • Understanding factors influencing integration quality is crucial.

Purpose of the Study:

  • To examine the integration process of Clinical Pharmacy Specialists (CPS) into primary care teams within the Veterans Health Administration (VHA).
  • To identify roles and influencing factors for CPS integration in PCMH.

Main Methods:

  • Semi-structured interviews were conducted with CPS (n=6) and clinical team members (n=16).
  • Thematic analysis of interview transcripts was performed to identify integration patterns and challenges.

Main Results:

  • Clinical Pharmacy Specialists (CPS) were integrated in two primary ways: consultative and collaborative roles.
  • Misconceptions about CPS competencies and provider opinions can limit integration to consultative roles.
  • Over time, misconceptions can be corrected, leading to more collaborative roles, such as comprehensive medication management for disease states.

Conclusions:

  • Collaborative integration enhances CPS opportunities to optimize contributions in primary care.
  • Clarifying roles is essential for effectively integrating advanced practitioners into interprofessional teams.
  • Successful integration of CPS supports improved patient care within the PCMH model.