Integrating Pharmacists into Medical Homes Significantly Improves Outcomes

Embedding a clinical pharmacist in established primary care medical home practices can yield big benefits, according to a new study published in the Journal of International Medical Research.

The study found that diabetes and hypertension patients who participated in Intermountain Healthcare's Collaborative Pharmacist Support Services (CPSS) program were more likely to achieve their disease management goals, improve their time to achievement, and increase their ambulatory encounters, compared to those patients not in the program.

Under the CPSS program, ambulatory care clinical pharmacists worked alongside physicians in Intermountain Healthcare's Medical Group primary care clinics to treat adult patients with diabetes or hypertension. The pharmacists worked with patients to initiate and adjust medications and ensure medications were being used safely and effectively.

Pharmacists also reviewed medication lists after hospitalizations, lowered drug costs by switching to generic or lower tier medications, worked with providers to determine the most optimal therapy for a given patient, and deprescribed potentially dangerous medications, according to a statement from Intermountain Healthcare, which is located in Salt Lake City.

When pharmacists worked collaboratively with physicians to provide patient care, the study's results showed that patients were 57% more likely to achieve an A1c level that was less than 8% and 93% more likely to achieve their blood pressure goal. In addition, according to the study, they were 87% more likely to achieve both disease management goals than those patients who did not participate in the CPSS program.

“What was so critical about this study was that the program was able to show a marked improvement for patients even when layered over a team-based care structure that’s already demonstrated improved quality outcomes and decreased annual cost as published earlier in 2016," Kim Brunisholz, PhD, Senior Scientist at Intermountain Healthcare's Institute for Healthcare Delivery Research said in the statement. 

The study demonstrates the value clinical pharmacists can provide in the direct management of chronic diseases and illustrates how integrations of this nature can improve the efficiency of primary-care teams.

"This could optimize operational utility, promote evidence-based change within a learning health-care system, and demonstrate improved adherence to clinical goals," Brunisholz and colleagues concluded in the study.

The study included data from 359 patients who were enrolled into the CPSS program between July 2012 and April 2015. This data was compared to data from 999 patients who were not enrolled in the program.