Clinical Pharmacy Priority Score May Improve Pharmacist Care Delivery


Ranking patients based on clinical pharmacy priority scoring can improve both drug outcomes and pharmacist-physician relationships.

Ranking patients based on clinical pharmacy priority scoring can improve both drug outcomes and pharmacist-physician relationships.

Joseph P. Vande Griend, PharmD, BCPS, CGP, and colleagues designed an algorithm to examine 11 patient-specific factors extracted from the electronic health record to determine the effects of clinical pharmacy priority scoring.

Researchers performed comprehensive drug reviews (CMRs) for 1,107 patients with clinical pharmacist appointments between October 2012 and December 2012 at 2 University of Colorado family practice clinics.

“The concept was that patients would come with appointments, and some of them have 1 to 2 drugs and don’t need a closer look because they’re pretty straightforward, but others have illnesses. really complicated, lots of drugs or patients who are older, ”said Dr Griend Pharmacy hours. “It became very clear that there was a need to define my population and the people I would look at. It would make me much more effective and efficient.

About 100 patients were identified as having received a drug recommendation from the clinical pharmacist. In total, the clinical pharmacist made 223 drug recommendations for 101 patient appointments, and nearly 60% were accepted and implemented by the patient’s physicians.

The majority of patients in this group had hypertension (84%), followed by diabetes (48%), vascular disease (26%), depression (22%) and chronic obstructive pulmonary disease (COPD) (8%) . Heart failure was present in 5% of the patients examined.

Patients with higher clinical pharmacy priority scores were more likely to have diabetes or hypertension, 6 or more medications on their list, and blood pressure> 140/90 mm Hg, the researchers noted. They were also more likely to receive a drug recommendation after CMR from a clinical pharmacist than patients with lower scores.

Based on these results, the researchers concluded that the clinical pharmacy priority scoring “could be used by clinical pharmacists in family medicine to improve the effective and efficient delivery of interprofessional care.”

Prior to the implementation of this scoring system, it took approximately 6 hours to review a complete weekly appointment list consisting of approximately 100 patients and provide a CMR for the selected patients. After implementation, the weekly hours required for this process were reduced to 1.5 hours.

“The health care system really needed to find a way to see how to use this expensive resource and make it as efficient as possible. You’re really targeting the people you want to see the most and the people you’re going to have the most impact on, ”said Dr Griend. “This is where health care is really going to move, and it is already. How can we use the limited resources we have and target them to specific patients? “

Dr Griend further explained that the doctor-pharmacist relationship also improved throughout the study’s observation period.

“The pharmacist may say, ‘Hey, your patient has a lot going on with his medications. I should really make a recommendation or see where we can improve things, ”he explained.

These results were published in the Journal of the American Board of Family Medicine.


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