The role of the pharmacist in patient-centered medical home practices: current perspectives

Figures & data

Table 1 Pharmacist contributions to PCMHs

Core attribute	Selected pharmacist services related to core attribute	Evidence of service value	Value to PCMHs
Improve quality and safety of care	Drug therapy assessment Medication therapy management Patient education Population management Drug safety alert monitoring Formulary and drug-utilization review monitoring Drug information services	Solid data that services can improve patient outcomes^Citation25^–^Citation41	Improvements in HEDIS scores and PCMH performance measures can lead to financial benefits
Coordination of care	Consultant for EHR development Medication list maintenance Medication reconciliation postdischarge	Limited data are available to support these services^Citation47^–^Citation52	Potential to improve meaningful use of EHRs, decrease adverse drug events, lower medication costs, and prevent hospital readmissions
Increased access to care	CPA Telephonic services Telemonitoring services	CPA cost effectiveness supported through demonstration projects^Citation15,Citation22,Citation54^–^Citation56 Limited data on telephonic and telemonitoring service benefits^Citation57^–^Citation60	Under capitated payment systems, expanding the population served will increase revenues

Abbreviations: CPA, collaborative practice arrangement; EHR, electronic health record; HEDIS, Healthcare Effectiveness Data and Information Set; PCMH, patient-centered medical home.

Table 2 Medication therapy management components in the patient-centered medical home

• Creation of a comprehensive and accurate list of all currently prescribed medications, nonprescription medications, and dietary supplements

• Assessment of medications for appropriateness, efficacy, and safety

• Assessment of barriers to adherence, such as complex regimen and cost of therapy

• Creation of an individualized set of recommendations aimed at optimizing medication use and achieving therapeutic goals

• Communication of recommendations to the patient

• Provision of culturally appropriate patient education

• Documentation of the recommendation plan and communication to appropriate care providers

Table 3 Population health pharmacist services

• Design and/or provision of interventions to assist PCMHs in meeting performance measures

• Use of patient registry and performance data to identify patients not meeting treatment goals or not receiving evidence-based care

• Development of protocols and/or the adoption of national clinical practice guidelines to assist the PCMH in providing evidence-based care

• Development of policies and procedures for managing drug recalls and shortages

• Development of policies and procedures to address FDA medication alerts

• Reviews of high-risk medication risks

• Design and/or provision of educational interventions

• Design and/or provision of medication adherence interventions

• Design and/or provision of educational programs for PCMH staff to improve medication record keeping, medication education and monitoring efforts

Abbreviations: FDA, Food and Drug Administration; PCMH, patient-centered medical home.

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