(1179) Use of Medication Therapy Problems to Demonstrate Value of Clinical Pharmacy Services in a Patient Centered Medical Home: A Mixed Methods Study

Objectives: The purpose of this study is to assess the impact of embedded ambulatory pharmacist services in primary care settings on provider availability. Objectives include (1) identifying common pharmacist interventions under collaborative practice agreements (CPA) in four patient-centered medical homes (PCMH) and (2) quantifying time saved by providers as a result of pharmacist interventions. This study addresses challenges in demonstrating the return on investment for pharmacist services in primary care and aligns with The Centers for Medicare and Medicaid Services support for pharmacists’ expanded roles in improving patient access to care.

Methods: Two full-time pharmacists provide comprehensive medication management in four PCMHs under a CPA which includes a detailed medication evaluation to identify and resolve medication therapy problems (MTPs). For each patient encounter, pharmacists document the MTP(s) identified, the medication(s) associated with the MTP(s), and interventions performed to resolve the MTP(s). This study employs a mixed-methods design, integrating quantitative and qualitative approaches. The quantitative aspect retrospectively characterizes MTPs from August 2022 to September 2023 and the qualitative component involves an anonymous provider survey exploring their perceptions of time spent on similar interventions. A thematic analysis of survey responses will identify patterns related to providers' perceptions of task duration; descriptive statistics will quantify pharmacist interventions related to MTPs and the respective perceived time-saved by providers.

Results: Institutional Review Board approval is anticipated in October 2023. Preliminary analysis shows 4,387 pharmacist documented MTPs during the study period. Up to 30 survey responses from providers are expected. Data will be analyzed in October 2023 and continued through the project completion in February of 2024.

Conclusions: Primary care clinics need effective solutions to combat critical gaps in patient care and increasing rates of physician burnout. This study uniquely demonstrates the value of embedded pharmacy services in primary care settings.