A new study shows pharmacists in patient-centred medical homes can boost vaccination rates and diabetes and hypertension outcomes
The study, Community Pharmacist Collaboration with a Patient Centered Medical Home: Establishment of a Patient-Centered Medical Neighborhood and Payment Model, was published in the Journal of the American Pharmacists Association.
It aimed to examine the feasibility of a partnership between a pharmacy and a Patient-Centred Medical Home by measuring the effect on office and patient-level clinical outcomes.
It described the collaboration between Kroger – a large grocery store chain which operates 102 pharmacies in the Cincinnati/Dayton, Ohio Marketing Area – and a medical practice which services more than 9000 patients in and around Cincinnati.
“A partnership between the community pharmacy chain and the PCMH was established to create a medical neighbourhood,” the authors write.
The pharmacist spent two half-days a week at the PCMH, providing one-on-one appointments with patients and building a rapport with the office staff as well as answering questions from prescribers and patients.
These appointments included medication therapy management, diabetes education and education on weight loss, as well as follow-up services in the office or pharmacy if these were desired.
The pharmacy received a capitated payment per patient per month for a pre-determined number of 1,000 high risk patients.
Between January 2013 and 2014, 105 patients participated in these pharmacist appointments – 1.5% of the total of those managed by the office.
“Office-level changes in clinical outcomes such as A1C, blood pressure, and lipid measures were collected and compared to a similar control office,” the authors wrote. “Additionally, patient-level outcomes such as change in A1C, blood pressure, lipids, and weight were measured.
“There was a statistically significant increase in influenza vaccinations received. On a patient-level, A1C and systolic blood pressure significantly improved.”
Mean HbA1C fell from 8.7% to 7.8% among patients with diabetes, while mean systolic blood pressure fell from 145mmHg to 127mmHg.
“This project represents an exciting opportunity for community pharmacists to expand their scope of services through direct partnership with PCMHs and maintain a sustainable reimbursement structure,” the authors concluded.