Initial experiences with a pharmacy clinic in a hospital-based group medical practice

Experiences in implementing a pharmacy clinic in a hospital-based primary-care group medical practice are described. A clinic was instituted through the joint support and active participation of the hospital administration and the departments of pharmacy and medicine. In the clinic, pharmacists monitored, assessed, and intervened in the drug therapy needs of patients who requested care or were referred by their primary-care physicians. Pharmacists provided services in 1751 patient visits during the first year of the clinic's operation. Clinic volume increased from two to 17 patients per session. Analysis of these patient visits showed that the pharmacists: (1) assessed physical signs in 60% of the patients, (2) ordered laboratory tests in 30%, (3) found a problem with the drug therapy in approximately one third of the patients, (4) detected new medical complaints in 4% of the patients, (5) initiated change in the drug regimen in 10% of the patient visits, and (6) referred almost 15% of the patients to new sources of care. In this clinic, pharmacists supplemented, not supplanted, the services of physicians for ambulatory patients.