JAPhA study: Community pharmacists enhance care in patient-centered medical home

More vaccinations, lower AIC and systolic blood pressure after pharmacist intervention

Community pharmacists who work directly with patients in a patient-centered medical home (PCMH) can help improve rates of influenza vaccination and improve outcomes in diabetes and hypertension management, according to a study published online in the Journal of the American Pharmacists Association. In the study, researchers describe a collaboration between Kroger Pharmacy and a medical practice that consisted of seven physicians, a registered dietician, and a medical home coordinator.

Between January 2013 and January 2014, a community pharmacist worked in the medical practice for 8 hours per week, divided into two 4-hour shifts. While in the office, the pharmacist provided one-on-one appointments with patients, built relationships with office staff, and answered patient and prescriber questions. Appointments with patients included medication therapy management, diabetes education, and weight loss education, as needed. The pharmacist also offered follow-up services in the office or the pharmacy as patients wished. Kroger Pharmacy received a fixed fee per patient per month for high-risk patients.

For the year evaluated in the study, 105 patients had appointments with the pharmacist. Medication review was the most common reason for referral, followed by diabetes education and weight loss counseling. Overall, the rate of documented influenza vaccinations was greater in the practice where the pharmacist worked compared with a control practice. Among patients who had appointments with the pharmacist, the mean A1C dropped from 8.7% to 7.8% for those with diabetes, and the mean systolic blood pressure decreased from 145 mmHg to 127 mmHg.  

In their conclusion, the researchers note that partnering with PCMHs offers an opportunity for community pharmacists to expand their scope of services while working in a sustainable reimbursement structure.