The Role of Pharmacy Through Collaborative Practice in an Ambulatory Care Clinic

Pharmacists have been practicing in ambulatory care environments managing patients with chronic illnesses since the 1970s. The US Surgeon General and the Centers for Disease Control and Prevention support pharmacists working in collaboration with physicians to optimize medication outcomes, improve patient satisfaction, and lower health care costs. Through collaborative practice agreements, pharmacists are able to work as part of a health care team with access to electronic health records, and they assist busy physicians manage patients with chronic diseases such as diabetes. This article will review the different types of ambulatory care practice settings, what is included in a collaborative practice agreement, the credentialing and privileging of pharmacists working in such environments, the qualifications of pharmacists, the scope of practice, and some challenges for reimbursement.

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Considerations for Providing Ambulatory Pharmacy Services for Pediatric Patients

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-23.1.4 ◽

2018 ◽

Vol 23 (1) ◽

pp. 4-17 ◽

Cited By ~ 1

Author(s):

Stacie J. Lampkin ◽

Brooke Gildon ◽

Sandra Benavides ◽

Kelly Walls ◽

Leslie Briars

Keyword(s):

Ambulatory Care ◽

Pharmacy Practice ◽

Health Care Team ◽

Pharmacy Services ◽

Limited Data ◽

Ambulatory Care Setting ◽

Care Clinic ◽

Enhance Patient Care ◽

Ambulatory Care Clinic

Pediatric clinical pharmacists are an integral part of the health care team. By practicing in an ambulatory care clinic, they can reduce the risk of medication errors, improve health outcomes, and enhance patient care. Unfortunately, because of limited data, misconceptions surrounding the role of pharmacists, and reimbursement challenges, there may be difficulty in establishing or expanding pediatric clinical pharmacy services to an ambulatory care setting. The purpose of this paper is to provide an overview of considerations for establishing or expanding pharmacy services in a pediatric ambulatory care clinic. The primer will discuss general and pediatric-specific pharmacy practice information, as well as potential barriers, and recommendations for identifying a practice site, creating a business plan, and integrating these services into a clinic setting.

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Patient Perceptions of Health Care at a University-Based Ambulatory Care Clinic

Journal of Ambulatory Care Management ◽

10.1097/00004479-198102000-00007 ◽

1981 ◽

Vol 4 (1) ◽

pp. 55-64 ◽

Cited By ~ 7

Author(s):

Morris Weinberger ◽

James Y. Greene ◽

Joseph J. Mamlin

Keyword(s):

Health Care ◽

Ambulatory Care ◽

Patient Perceptions ◽

Care Clinic ◽

Ambulatory Care Clinic

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Pharmacist Hypertension Management Quality Review at an Ambulatory Care Clinic

Journal of Pharmacy Technology ◽

10.1177/87551225211064240 ◽

2021 ◽

pp. 875512252110642

Author(s):

Kayla Chonko ◽

Sandra Axtell ◽

Bianca Mayzel

Keyword(s):

Blood Pressure ◽

Ambulatory Care ◽

Small Sample Size ◽

Small Sample ◽

Blood Pressure Goal ◽

Care Clinic ◽

Prospective Group ◽

Collaborative Practice Agreement ◽

Ambulatory Care Clinic ◽

The Impact

Background: A reduction of 10 mm Hg in systolic blood pressure (SBP) significantly decreases the risk of major cardiovascular disease events. Pharmacists’ management of blood pressure may assist with this reduction. Objective: Assess the impact of pharmacist management of hypertension via a collaborative practice agreement with physicians in an ambulatory care clinic. Methods: The first phase of this study was a retrospective chart review of physician/nurse hypertension visits from October 2019 to August 2020. The second prospective phase consisted of pharmacist managed hypertension visits from December 2020 to January 2021. The primary outcome was the change in SBP from the beginning to the end of the study period in the prospective group. Secondary outcomes included the proportion of patients achieving their blood pressure goal and the proportion of patients adherent to all antihypertensive medications at their follow-up visits in both groups. This study was institutional review board approved. Results: Forty-seven patients were included and analyzed (24 in the retrospective group and 23 in the prospective group). Patients in the prospective group had an average SBP lowering of 10.83 mm Hg ( P = .0035). Thirteen patients (56.5%) met their blood pressure goal of <130/80 mm Hg in the prospective group, compared to 5 patients (20.8%) in the retrospective group ( P = .012). One adverse event occurred during this study. Limitations included small sample size and short duration of study. Conclusion: Patients had an average SBP lowering of >10 mm Hg. More patients reached a goal blood pressure of <130/80 mm Hg when managed by pharmacists.

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Challenges to and Resources for Participation in Interprofessional Collaborative Practice: Perceptions of Collegiate Athletic Trainers

Journal of Athletic Training ◽

10.4085/1062-6050-507-17 ◽

2019 ◽

Vol 54 (1) ◽

pp. 106-114

Author(s):

Sarah A. Manspeaker ◽

Dorice A. Hankemeier

Keyword(s):

Health Care ◽

Interprofessional Education ◽

Health Care Systems ◽

Athletic Trainers ◽

Health Care Team ◽

Collaborative Practice ◽

College And University ◽

Interprofessional Collaborative Practice ◽

Care Systems ◽

Collegiate Athletic Trainers

Context Health care systems are increasing their emphasis on interprofessional collaborative practice (IPCP) as a necessary component to patient care. However, information regarding the challenges athletic trainers (ATs) perceive with respect to participating in IPCP is lacking. Objective To describe collegiate ATs' perceptions of challenges to and resources for participation in IPCP. Design Qualitative study. Setting College and university. Patients or Other Participants The response rate was 8% (513 ATs [234 men, 278 women, 1 preferred not to disclose sex], years in clinical practice = 10.69 ± 9.33). Data Collection and Analysis Responses to survey-based, open-ended questions were collected through Qualtrics. A general inductive qualitative approach was used to analyze data and establish relevant themes and categories for responses. Multianalyst coding and an external auditor confirmed coding saturation and assisted in triangulation. Results Challenges were reported in the areas of needing a defined IPCP team structure, respect for all involved health care parties, and concerns when continuity of care was compromised. Communication was reported as both a perceived challenge and a resource. Specific resources seen as beneficial to effective participation in IPCP included communication mechanisms such as shared patient health records and educational opportunities with individuals from other health care professions. Conclusions As ATs become more integrated into IPCP, they need to accurately describe and advocate their roles, understand the roles of others, and be open to the dynamic needs of team-based care. Development of continuing interprofessional education opportunities for all relevant members of the health care team can help to delineate roles more effectively and provide more streamlined care with the goal of improving patient outcomes.

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