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A Retrospective Evaluation of a Pharmacist-Driven Urgent Care Microbiology Review Program
John P Bomkamp1, Benjamin V Craft1,2, Holly Nuest1
1Indiana University Health Arnett Hospital, Lafayette, Indiana, USA.
Background:
Pharmacist-driven microbiology review programs have been thoroughly described in the emergency department setting. However, there is limited evidence for programs in outpatient settings, especially for urgent care settings. The purpose of this study is to evaluate a pharmacist-driven urgent care microbiology review program to determine the impact of its implementation.
Methods:
This retrospective cohort study evaluated urgent care patients who did not receive appropriate treatment based on urine, wound, or respiratory culture, or select sexually transmitted infection testing. A pharmacist-driven microbiology review program at two urgent cares was compared to 11 other urgent cares using only physician/advanced practice provider (APP) review of microbiology results. The primary end point was the time to appropriate treatment in hours from finalized result to prescription of appropriate treatment. Secondary end points included time to appropriate treatment in calendar days and unplanned 30-day revisit rate.
Results:
A total of 400 patients were included in this study (pharmacist-driven, n = 200; physician/APP, n = 200). Time to appropriate treatment in hours was 11 h in the pharmacist-driven cohort and 13 h in the physician/APP cohort (p = 0.047). Unplanned 30-day revisit rate was similar between the two groups (pharmacist-driven 14% versus physician/APP 12.5%, p = 0.658).
Conclusion:
A pharmacist-driven urgent care microbiology review program achieved a similar time to appropriate antimicrobial treatment compared with a physician/APP process while maintaining comparable clinical outcomes.
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