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Benefits of integrating comprehensive medication management pharmacists into specialty clinics: Lessons learned from
Background:
Comprehensive medication management (CMM) pharmacists have demonstrated value in primary care through optimizing medications and improving clinical outcomes. Given the complexity, cost, and adherence challenges associated with specialty medications, integrating CMM services into specialty clinics may enhance the management of complex disease states.
Objective:
To describe the implementation of a program embedding CMM pharmacists within 3 specialty inflammatory clinics.
Practice Description:
Within a large, academic health system, CMM services were expanded to dermatology, gastroenterology, and rheumatology clinics.
Practice Innovation:
The CMM program expanded to support patients in inflammatory clinics through ensuring patient safety, improving medication adherence, and enhancing patient outcomes through personalized care and standardized medication optimization.
Evaluation Methods:
Adult patients seen by CMM pharmacists between July 2023 and June 2024 in 3 specialty inflammatory clinics were examined to determine the completion of health maintenance metrics (including baseline screenings and vaccines), and medication therapy problems (MTPs) documented. The Net Promoter Score measured patient satisfaction with CMM services.
Results:
A total of 2856 patients completed 5218 CMM pharmacist specialty visits. Most patients (N = 2344, 82.1%) were prescribed a specialty medication, and most patients on specialty medications had all baseline screening accomplished (N = 1807, 77.1%), with vaccine rates ranged from 54.6% (zoster) to 91.4% (tetanus, diphtheria, and pertussis). There were 3759 MTPs documented, of which needing additional medication therapy (N = 1691, 45.0%) was most common; 94.0% of MTPs were accepted. Overall, patient satisfaction scores were 86.3%.
Conclusion:
Pharmacist-led CMM visits, traditionally rooted in primary care, can be successfully integrated into specialty clinics to bolster health maintenance needs and resolve MTPs to help optimize therapies, while maintaining patient satisfaction rates. This model of pharmacy supports broader adoption of CMM within specialty care, offering potential benefits to patients, providers, and payers such as reduced health care costs, decreased provider administrative burden, and improved patient outcomes.
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