Increasing rural patient access using clinical pharmacy specialist providers: Successful practice integration within the Department of Veterans Affairs

Abstract Purpose Access to care is a critical issue facing healthcare and affects patients living in rural and underserved areas more significantly. This led the Department of Veterans Affairs (VA) to launch a project that leveraged the expertise of the clinical pharmacy specialist (CPS) provider, embedding 180 CPS providers into primary care, mental health, and pain management across the nation. Methods This multidimensional project resulted in hiring 111 CPS providers in primary care, 40 CPS providers in mental health, and 35 CPS providers in pain management to serve rural veterans’ needs. From October 2017 to March 2020, CPS providers provided direct patient care to 213,477 veterans within 606,987 visits. This was an average of 43,000 additional visits each quarter to support comprehensive medication management services, demonstrating an additional 219,823 visits in fiscal year 2018 and 232,030 visits in fiscal year 2019. Over the course of the project, the team provided mentorship to 164 CPS providers, performed consultative visits at 27 VA facilities, and trained 180 CPS providers in educational boot camps. Conclusion VA funding of rural health initiatives adding CPS providers to primary care, mental health, and pain teams has resulted in positive measures of comprehensive medication management, interdisciplinary team satisfaction, facility leadership acceptance, and multiple positive outcomes.

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Primary care-mental health integration in healthcare in the Department of Veterans Affairs.

Families Systems & Health ◽

10.1037/a0020341 ◽

2010 ◽

Vol 28 (2) ◽

pp. 78-82 ◽

Cited By ~ 27

Author(s):

Andrew S. Pomerantz ◽

Steven L. Sayers

Keyword(s):

Mental Health ◽

Primary Care ◽

Veterans Affairs ◽

Department Of Veterans Affairs ◽

Primary Care Mental Health ◽

Mental Health Integration

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Evaluation of clinical pharmacy services within the primary care–mental health integration model at the Tuscaloosa Veterans Affairs Medical Center

Mental Health Clinician ◽

10.9740/mhc.2016.09.260 ◽

2016 ◽

Vol 6 (5) ◽

pp. 260-265 ◽

Cited By ~ 2

Author(s):

Mamta Parikh ◽

Ekaette E. Ebong ◽

Erin Harris ◽

Brittany Barnes

Keyword(s):

Mental Health ◽

Primary Care ◽

Clinical Pharmacy ◽

Medical Center ◽

Veterans Affairs ◽

Pharmacy Services ◽

Specialty Mental Health ◽

Primary Care Mental Health ◽

Number Of Patients ◽

Mental Health Integration

Abstract Introduction: The purpose of this review is to evaluate the direct delivery of health care to veterans before and after incorporating clinical pharmacy services within primary care mental health integration (PCMHI) at the Tuscaloosa Veterans Affairs Medical Center. Prior to establishing the role of the clinical pharmacy specialist (CPS) within PCMHI, the primary care providers deferred all mental health assessments to specialty mental health. As the demands of the service grew exponentially, assistance from clinical pharmacy was critical. Methods: A randomized, computer-generated list of 114 patients selected for the retrospective chart review was used to evaluate clinical outcomes in patients enrolled in the PCMHI clinic 1 year preincorporation and postincorporation of CPS. Outcome measures included the number of patients discharged from the PCMHI clinic upon achieving therapeutic goals or discharged to specialty mental health due to therapeutic failure or adverse drug events with first- and second-line psychotropic agents. Results: When contrasting the end points, there was a 60% increase in the number of patients who achieved therapeutic goal and a 32% decrease in the number of patients discharged to specialty mental health clinic postincorporation of CPS into PCMHI as compared to preincorporation of CPS (P = .024). Discussion: The results support the significance of CPS in the PCMHI in providing pharmacotherapy, patient education, and medication monitoring for managing psychiatric conditions, such as depression, anxiety, and insomnia. In addition, patients had greater accessibility to medication and frequent monitoring and follow-up, ultimately improving patient outcomes.

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