Pharmacy Benefits Management Services, US Department of Veterans Affairs, Washington, DC.
Am J Health Syst Pharm. 2021 Mar 31;78(8):712-719. doi: 10.1093/ajhp/zxab011.
Access to care is a critical issue facing healthcare and affects patients living in rural and underserved areas more significantly. This led the Department of Veterans Affairs (VA) to launch a project that leveraged the expertise of the clinical pharmacy specialist (CPS) provider, embedding 180 CPS providers into primary care, mental health, and pain management across the nation.
This multidimensional project resulted in hiring 111 CPS providers in primary care, 40 CPS providers in mental health, and 35 CPS providers in pain management to serve rural veterans' needs. From October 2017 to March 2020, CPS providers provided direct patient care to 213,477 veterans within 606,987 visits. This was an average of 43,000 additional visits each quarter to support comprehensive medication management services, demonstrating an additional 219,823 visits in fiscal year 2018 and 232,030 visits in fiscal year 2019. Over the course of the project, the team provided mentorship to 164 CPS providers, performed consultative visits at 27 VA facilities, and trained 180 CPS providers in educational boot camps.
VA funding of rural health initiatives adding CPS providers to primary care, mental health, and pain teams has resulted in positive measures of comprehensive medication management, interdisciplinary team satisfaction, facility leadership acceptance, and multiple positive outcomes.
医疗保健面临的一个关键问题是获得医疗服务的机会，这对居住在农村和服务不足地区的患者影响更大。这导致退伍军人事务部（VA）启动了一个项目，利用临床药师专家（CPS）提供者的专业知识，在全国范围内将 180 名 CPS 提供者嵌入到初级保健、心理健康和疼痛管理中。
这个多方面的项目导致在初级保健中雇用了 111 名 CPS 提供者，在心理健康中雇用了 40 名 CPS 提供者，在疼痛管理中雇用了 35 名 CPS 提供者，以满足农村退伍军人的需求。从 2017 年 10 月到 2020 年 3 月，CPS 提供者在 606,987 次就诊中为 213,477 名退伍军人提供了直接的患者护理。这意味着每个季度平均增加了 43,000 次就诊，以支持全面的药物管理服务，在 2018 财年增加了 219,823 次就诊，在 2019 财年增加了 232,030 次就诊。在项目实施过程中，该团队为 164 名 CPS 提供者提供了指导，在 27 个 VA 设施进行了咨询访问，并在教育训练营中培训了 180 名 CPS 提供者。
VA 为农村卫生倡议提供资金，在初级保健、心理健康和疼痛团队中增加 CPS 提供者，已经带来了全面药物管理、跨学科团队满意度、设施领导接受度和多个积极结果的积极措施。
