Identification of Drug Therapy Problems and Prescriber Acceptance of Pharmacist Recommendations in a Medication Therapy Management Service - A Retrospective Review

Identification of Drug Therapy Problems and Prescriber Acceptance of Pharmacist Recommendations in a Medication Therapy Management Service: A Retrospective Review, is a project designed to assess prescriber response to recommendations provided by pharmacists in an ambulatory care setting. The PharmacistCARE DiabetesCARE program is a diabetes education and management service made up of a team of pharmacist educators. The mission of PharmacistCARE is to help the public understand the medications they take and to control chronic health conditions through the most effective use of medications. Patients follow up with a pharmacist individually every 1-3 months upon completion of 6 hours of group education. In the individual sessions pharmacists assess medication adherence, medication changes, behavioral goals, American Diabetes Association (ADA) standards of care, complications, lab values (Alc, lipids, urine microalbumin, serum creatinine, LFTs), and self-monitoring blood glucose (download and review BG results from patient's personal meter). Physical assessment (weight, BP, sensory foot exam) is also performed. Each visit is documented and recommendations are sent to the patient's health care provider(s). Each recommendation made by a pharmacist is documented on a Pharmacist Intervention Form. This form is broken down into categories and is used to track drug therapy problems. Retrospectively, these recommendations made by pharmacists to the prescriber, generally the patient's primary care provider, will be assessed to determine acceptance by the prescriber. This project is significant to pharmacy practice because it will help determine if pharmacists are able to effectively impact resolution of drug therapy problems through recommendations alone or if further use of collaborative care agreements (CCAs) are needed to affect change. In addition, CCAs as defined by the state's pharmacy practice act are somewhat restrictive and challenging to implement. This project may identify the need to pursue legislative changes to eliminate some of the barriers to these agreements. OBJECTIVES The primary research objective is to measure the percentage of recommendations primary care providers accepted from pharmacist interventions. Secondary objectives: 1. To assess the length of time for a pharmacist recommendation to be accepted 2. To determine the cost savings involved for non-formulary recommendations