Integration of Clinical Pharmacist Services into an Underserved Primary Care Clinic Utilizing an Interprofessional Collaborative Practice Model

Integrative medicine (IM) is a clinical paradigm of whole person healthcare that combines appropriate conventional and complementary medicine (CM) treatments. Studies of integrative healthcare systems and theory-driven evaluations of IM practice models need to be undertaken. Two health services research methods can strengthen the validity of IM healthcare studies, practice theory, and fidelity evaluation. The University of Arizona Integrative Health Center (UAIHC) is a membership-supported integrative primary care clinic in Phoenix, AZ. A comparative effectiveness evaluation is being conducted to assess its clinical and cost outcomes. A process evaluation of the clinic’s practice theory components assesses model fidelity for four purposes: (1) as a measure of intervention integrity to determine whether the practice model was delivered as intended; (2) to describe an integrative primary care clinic model as it is being developed and refined; (3) as potential covariates in the outcomes analyses, to assist in interpretation of findings, and for external validity and replication; and (4) to provide feedback for needed corrections and improvements of clinic operations over time. This paper provides a rationale for the use of practice theory and fidelity evaluation in studies of integrative practices and describes the approach and protocol used in fidelity evaluation of the UAIHC.

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Evaluating the role and value of a clinical pharmacist in a concierge primary care clinic

Journal of the American Pharmacists Association ◽

10.1016/j.japh.2020.12.014 ◽

2021 ◽

Author(s):

Annette De Santiago ◽

Jennifer M. Bingham ◽

Shannon Vaffis ◽

Nicole Scovis ◽

Emily McGlamery ◽

...

Keyword(s):

Primary Care ◽

Clinical Pharmacist ◽

Primary Care Clinic ◽

Care Clinic

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An Interprofessional Collaborative Practice Model: Primary-Care Clinical Associates at the Family Practice Setting

Healthcare Management Forum ◽

10.1016/j.hcmf.2010.08.005 ◽

2010 ◽

Vol 23 (4) ◽

pp. 159-163 ◽

Cited By ~ 1

Author(s):

Jessica S.E. Moe ◽

Allan L. Bailey ◽

Stanley Kroeker ◽

Grace Moe

Keyword(s):

Primary Care ◽

Family Practice ◽

Collaborative Practice ◽

Practice Setting ◽

Practice Model ◽

Interprofessional Collaborative Practice ◽

The Family

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Patient Satisfaction with Pharmacist-Provided Health-Related Services in a Primary Care Clinic

Pharmacy ◽

10.3390/pharmacy9040187 ◽

2021 ◽

Vol 9 (4) ◽

pp. 187

Author(s):

Jacob N. Jordan ◽

Thomas G. Wadsworth ◽

Renee Robinson ◽

Hayli Hruza ◽

Amy Paul ◽

...

Keyword(s):

Primary Care ◽

Patient Satisfaction ◽

Clinical Pharmacist ◽

Primary Care Clinic ◽

Perceived Value ◽

Care Facility ◽

Healthcare Services ◽

Related Services ◽

Care Clinic ◽

Health Related

(1) Background: Patient satisfaction plays an important role in the perceived value, sustained utilization, and coverage of healthcare services by payers and clinics. (2) Methods: A 33-question survey was designed to assess patient satisfaction and perceived value for healthcare services provided by a clinical pharmacist in a single primary care facility. It included general items from validated patient satisfaction surveys (i.e., PROMIS®, CAHPS) and pharmacist-specific items identified in selected literature. It was offered to all patients who were presenting for a new, unique visit with the clinical pharmacist at the medical clinic between May 2019 and April 2020. (3) Results: A total of 66 patients agreed to take the survey (RR = 100%), and the responses were overwhelmingly positive. However, men were more likely than women to report higher satisfaction (X2(1, n = 920) = 0.67, p = 0.027), and new patients reported higher satisfaction than existing patients (X2(1, n = 1211) = 1.698, p = 0.037). (4) Conclusions: The findings of this study indicate a high degree of patient satisfaction with pharmacist-provided healthcare services in the primary care setting.

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Impact of a clinical pharmacist on provider prescribing patterns in a primary care clinic

Journal of the American Pharmacists Association ◽

10.1016/j.japh.2021.10.007 ◽

2021 ◽

Author(s):

Erin T. Wei ◽

Patrick Gregory ◽

David J. Halpern ◽

Makeba Felton ◽

Benjamin A. Goldstein ◽

...

Keyword(s):

Primary Care ◽

Clinical Pharmacist ◽

Primary Care Clinic ◽

Prescribing Patterns ◽

Care Clinic

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Pharmacist Review to Simplify Medication Regimens in a VAMC Primary Care Clinic

Journal of Pharmacy Technology ◽

10.1177/875512259601200206 ◽

1996 ◽

Vol 12 (2) ◽

pp. 62-66 ◽

Cited By ~ 4

Author(s):

Paul V Laucka ◽

Will B Webster ◽

Jeffrey Kuch

Keyword(s):

Primary Care ◽

Clinical Pharmacist ◽

Primary Care Clinic ◽

Intervention Group ◽

Pharmacist Intervention ◽

Control Group ◽

Care Clinic ◽

Before And After ◽

Clinical Pharmacist Intervention ◽

Clinic Visits

Objective: To assess the effect of a clinical pharmacist's prospective medication review of patients receiving multiple drug therapy, using the pharmaceutical care process, as determined by the number of concurrent medications the patient is receiving before and after clinic visits. Design: Assigned groups. Setting: Outpatient primary care clinic of a tertiary healthcare Veterans Affairs (VA) medical facility. Patients: Seven hundred twenty-seven patients who had eight or more active medication orders were selected. Four hundred forty-one patients (aged 67.2 ± 10.4 y) were in the intervention group; 286 others (aged 66.6 ± 11.9 y), whose medical records were not available, were assigned to the control group and received no clinical pharmacist intervention. Intervention: Medication regimens of VA ambulatory patients with eight or more active medications were reviewed by a clinical pharmacist, and a written communication to the prescriber was attached to the medical record. Main Outcome Measures: The number of active concurrent medications before and after clinic visits was measured. Results: There was a decrease in the medications in the intervention group from an average of 12.1 ±4 to 11.5 ± 4.2 (p < 0.05). The medications in the control group rose from an average of 11.8 ± 4.44 to 12.2 ± 4 (p = NS). A decrease of 0.6 prescriptions per patient was highly significant (p < 0.05). During the study, 1,336 recommendations were made to practitioners. From this group, 41% of the recommendations were accepted, and 477 medications were discontinued, the quantity dispensed or dosage was reduced, or an alternative medication was prescribed. Conclusions: These data suggest that clinical pharmacist intervention in an ambulatory care setting can affect practitioner prescribing habits and significantly decrease the number of medications prescribed.

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