Integration of pharmacy services into an outpatient specialty clinic

Introduction: Specialty pharmacy focuses on high cost, high touch medication therapy for patients with complex diseases. These patients often need additional support and resources to overcome barriers such as medication cost, coverage, and complexity. New pharmacy practice models involve interdisciplinary teams of physicians, nurses, and pharmacists and provide improved patient compliance, accessibility, convenience, and patient confidence. CoxHealth recently started a Multiple Sclerosis (MS) Specialty Medication Management Program in September 2015, at their Center for Health Improvement Clinic. This research study is being conducted to assess specialty pharmacy services being used as part of this new program.

Objectives: Primary objective is to examine service line metrics related to pharmacy services integration; specifically, patient and provider satisfaction, number and type of pharmacist intervention, recommendation acceptance rate, patient medication adherence, and patient work productivity. Secondary objective is to assess disease state metrics.

Study Design: Single-center, service-based quality improvement study

Methods: Participants are adults 18 and older who are participants of the CoxHealth insurance plan and received care at the specialty clinic. Individuals are excluded if they choose not to participate in the program. The primary investigator will be responsible for facilitating all study-related activities. Patient and provider satisfaction surveys will be used. Data to assess other study objectives will be obtained from patient charts. Descriptive statistics will be used to describe primary and secondary outcomes. This study was approved by the Western Institutional Review Board.

Results: Preliminary data has been assessed for 20 eligible patients. Average age is 47.1 years and 60% are female. 19 patients have relapsing remitting MS and one has secondary progressive MS. Patient population averages 0.58 relapses per year, 5.46 second 25-foot walking time, 1.39 on MS disease steps scale, 33.01/35.42 on MSIS-29, 4.35 FSS score, and 3 EDMUS score.

Conclusions: Estimated completion date of May 1, 2016