Specialty Pharmacy Services, University of Iowa Health Care, Iowa City, IA.
Department of Pediatrics, University of Iowa Health Care, Iowa City, IA.
Am J Health Syst Pharm. 2020 Oct 14;77(21):1771-1777. doi: 10.1093/ajhp/zxaa246.
To describe clinical pharmacy specialists' role in improving the use of specialty medications within a pediatric outpatient setting.
The outpatient pediatric specialty clinic (PSC) at the University of Iowa added a clinical pharmacy specialist to multidisciplinary teams within the PSC to focus on patient education, providing clinical recommendations, coordinating insurance approval, addressing barriers to adherence, and performing follow-up monitoring. Supplemental activities include coordinating between the electronic health record-integrated on-site specialty pharmacy and the PSC, assisting with quality improvement projects, developing policy revisions, negotiating access to specialty products, and answering medication information questions. Benefits in workflow efficiency, documentation, and revenue generation resulting from implementation of the pharmacist within the PSC have been identified by the clinic and the specialty pharmacy. The specialty pharmacy identified an increase in the rate of specialty prescription capture from 14% to 50%, leading to an increase in revenue for the health system. Within 12 months of the addition of the pharmacist to the team, an improvement in the rate of 13-valent pneumococcal conjugate vaccine administration to pediatric patients of 25.7 percentage points, medication adherence of >90%, and a 75% relative increase in appropriate hydroxychloroquine dosing were recognized. Due to the pharmacist's impact on the PSC, a full-time pharmacist was added to the pediatric team to cover additional clinics, and 2 benefits investigation technicians were hired and funded by the PSC.
An interdisciplinary team with an integrated pharmacist has facilitated sustainable improvements in medication access and adherence and clinical and quality measures, benefiting patients, the pediatric clinic, the specialty pharmacy, and the hospital organization.
描述临床药师在改善儿科门诊专科药物使用方面的作用。
爱荷华大学的儿科专科门诊（PSC）在多学科团队中增加了一名临床药师，专注于患者教育、提供临床建议、协调保险审批、解决用药依从性障碍问题，并进行随访监测。补充活动包括协调电子病历集成的现场专科药房与 PSC 之间的工作、协助质量改进项目、制定政策修订、协商获取专科产品的途径以及解答药物信息问题。PSC 和专科药房都发现了药剂师在 PSC 中实施所带来的工作流程效率、文档记录和收入增长方面的好处。专科药房发现专科处方捕获率从 14%提高到 50%，这导致了医疗系统收入的增加。在药剂师加入团队后的 12 个月内，儿童患者 13 价肺炎球菌结合疫苗接种率提高了 25.7 个百分点，用药依从性>90%，羟氯喹合理剂量的相对增加了 75%。由于药剂师对 PSC 的影响，儿科团队增加了一名全职药剂师，以覆盖更多的诊所，并且由 PSC 雇佣并资助了 2 名福利调查技术人员。
一个具有整合药剂师的跨学科团队促进了药物获取和依从性以及临床和质量措施的可持续改善，使患者、儿科诊所、专科药房和医院组织受益。
