Primary Care Pharmacist Impact on Healthcare Utilization



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Purpose: To implement a pharmacy service in a primary care practice designed to improve patient quality of care demonstrated by decreased rate of 30-day healthcare utilization.

Summary: In response to the lack of literature describing pharmacist impact on healthcare utilization, University of Houston and the pharmacy department at Houston Methodist Hospital (HMH) studied the effect of clinical services provided by a pharmacist to 484 patients seen in a medical resident ambulatory clinic (pilot population). The pilot population was evaluated and compared to 407 patients not receiving these services (pre-pilot population). Results show a significant decline (P = 0.03) in hospitalizations, with patients having a 62% reduction in the risk of hospitalization in the pilot population, and an increase (P < 0.001) in number of uncontrolled hypertensive patients receiving hypertension medication interventions. The percent of patients with a diagnosis of hypertension (P= 0.03) was higher in the pre-pilot population 41.5% (169/407) when compared to 35% (170/484) in the pilot population. Key components of the model include (1) pharmacist-driven medication reconciliation and patient education (2) pharmacist participation in multidisciplinary clinic rounds and (3) targeted uncontrolled disease state medication interventions. The ultimate goal is enhanced patient-driven inter-professional collaboration to decrease healthcare utilization.

Conclusion: Pharmacy services in primary care are beneficial as shown by decreased hospital utilization and pharmacists should become involved in long-term outpatient care given to primary care patients.



Ambulatory Care, Interprofessional, Pharmacy, Primary care