Objective:
The purpose of this report is to characterize the patient population
served by the Grace Lamsam Pharmacy Program and to describe program
outcomes.
Methods: A chart review was conducted for all patients (n=100)
participating in the Grace Lamsam Pharmacy Program from January
1, 2007 to February 6, 2008. The primary outcome data collected
were the medication related problems (unnecessary drug therapy,
needs additional drug therapy, ineffective drug therapy, dosage
too low, dosage too high, adverse drug reaction, noncompliance,
and needs different drug product) identified by pharmacists, the
number and type of pharmacist interventions made, estimated cost
savings from perspective of the patient and clinical data (hemoglobin
A1C, blood pressure measurements, and LDL-C) for patients with
diabetes, hypertension, and hyperlipidemia, respectively. Basic
demographic data was collected, including: patient gender, age,
education level, race/ethnicity, marital status, and income. Patients’
smoking status, type and number of medical conditions, medications
being used at baseline, and number of pharmacist visits per patient
during the study review period were also recorded.
Results: The majority of patients cared for were male, middle-aged,
and African-American. The majority (90%) of patients had an income
below 150% of the 2007 Federal poverty level. Patients were most
commonly treated for diabetes, hypertension, and hyperlipidemia.
During the period of review, 188 medication related problems were
identified and documented with noncompliance being the most common
medication related problem identified. Pharmacists completed 477
Pharmaceutical Manufacturer Assistance Program applications for
68 patients. These interventions represented a cost savings from
the patients’ perspective of approximately 243 USD per month during
the review period. Blood pressure, A1C, and LDL-C readings improved
in patients enrolled in the clinical pharmacy program at the free
clinic and the community health center.
Conclusion: A clinical pharmacy services model provides a role
for the pharmacist in an interdisciplinary team (beyond the traditional
dispensing role) to identify medication related problems in the
drug therapy of patients who utilize safety-net provider health
care services.
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