An off-site clinical pharmacy service in family medicine: development and 1-year outcomes.

BACKGROUND AND OBJECTIVES

Clinical pharmacists are a part of integrated health care teams and provide clinical medication recommendations for family physicians. On-site clinical pharmacy services are common in family medicine. This model may not be the most effective or efficient way to provide clinical pharmacy services in a small practice or in a remote location. The objectives of this study were to describe the development of an off-site clinical pharmacy service and to describe the 1-year clinical impact of this service.

METHODS

The University of Colorado Park Meadows Family Medicine Clinic is located approximately 15 miles from the Anschutz Medical Campus. In July 2011, a clinical pharmacist implemented clinical pharmacy services with the goal of providing medication expertise primarily using an off-site model. The clinical pharmacist prospectively screened patients with appointments and provided medication recommendations in the electronic medical record for providers to consider at the patient appointment.

RESULTS

For the first 12 months, the clinical pharmacist spent 118 hours providing the clinical pharmacy service. A total of 315 medication recommendations were made for 123 patients; 69.8% were implemented. Forty-nine vaccinations were administered, and 24 potentially dangerous major drug-drug interactions were identified and resolved. Thirty-one unnecessary high-cost drugs were discontinued, resulting in estimated annual savings of $52,215.36.

CONCLUSIONS

Our data indicate that clinical pharmacy services can be implemented for smaller remote family clinics using an offsite model. Within this model, clinical pharmacy interventions optimized medication use, managed serious drug interactions, and resulted in cost avoidance.