Integrate Services Into Virtual Ambulatory Care Clinics

Pharmacists can expand access to health care, enhance patient safety, and improve patient outcomes by providing virtual services, according to a 2017 position statement from the American Society of Health-System Pharmacists.¹

Telepharmacy is the remote delivery of pharmaceutical care by qualified professionals.¹ The COVID-19 pandemic led to an increase in the amount of health care in the United States provided using a variety of technological platforms.² Now pharmacists can play a significant role in the management of medication therapy through virtual ambulatory care clinics in the diabetes area (Figure^2-5).

Integrating MTM Services Via Telehealth

There was an estimated 78-fold increase in the use of telepharmacy services in the United States during the COVID-19 pandemic. Virtual educational programs offering drug information, adherence tips, and advice on lifestyle modifications to manage prediabetes and diabetes have been successful. Pharmacist-led multidisciplinary ambulatory care clinics have been associated with better diabetes control, access to health care, and medication adherence.^2,3

Rural areas have also benefited from remote medication therapy management (MTM). At a family medicine clinic serving 4 counties in Florida, the ambulatory care pharmacist and 2 ambulatory care residents established a collaborative practice agreement with physicians to offer telephonic MTM consults and video telemedicine for patients with chronic diseases. The pharmacist initiated the video calls, and physicians participated in the care plan development. Through this, they conducted 17 telephonic and 7 collaborative telehealth MTM video calls over a 2-month period.⁴

Another success story is that of an Indiana health care system that covered an 11-county region. Pharmacists there offered telephone and video MTM consults. New patients, those on opioid therapy, and those requiring new-device training had to use the video platform. Virtual consults included annual wellness visits, chronic disease management, and health maintenance. More than 900 telemedicine visits were conducted, and more than 10% were completed on the video platform.⁴

One large health care system in Utah offered pharmacist-led multidisciplinary MTM services as part of primary care. The multidisciplinary team included a medical director, an advanced practice provider, a nurse manager, a pharmacist, and a social worker. Pharmacist MTM consults increased by 22%, and the health care system was able to reduce gaps in care for patients with chronic conditions.⁴

Doximity telehealth tools, such as digital faxing, no-reply texting, and video and voice calling on Apple and Android devices, are available free of charge to all US pharmacists for MTM consults. The Doximity application also offers medical news and networking opportunities.⁵

About The Author

Jennifer Gershman, PharmD, CPh, PACS, is a drug information pharmacist and Pharmacy Times® contributor who lives in South Florida.

References

1. Alexander E, Butler CD, Darr A, et al. ASHP statement on telepharmacy. Am J Health Syst Pharm. 2017;74(9):e236-e241. doi:10.2146/ajhp170039

2. Elnaem MH, Nuffer W. Diabetes care and prevention services provided by pharmacists: progress made during the COVID-19 pandemic and the need for additional efforts in the post-pandemic era. Explor Res Clin Soc Pharm. 2022;6:100137. doi:10.1016/j.rcsop.2022.100137

3. Reardon J, Yuen J, Lim T, Ng R, Gobis B. Provision of virtual outpatient care during the COVID-19 pandemic and beyond: enabling factors and experiences from the UBC Pharmacists Clinic. Innov Pharm. 2020;11(4):10.24926/iip.v11i4.3432. doi:10.24926/iip.v11i4.3432

4. DeRemer CE, Reiter J, Olson JL. Transitioning ambulatory care pharmacy services to telemedicine while maintaining multidisciplinary collaborations. Am J Health Syst Pharm. 2021;78(5):371-375. doi:10.1093/ajhp/zxaa427

3. Doximity dialer now free for all U.S. pharmacists and pharmacy students. Doximity. June 15, 2022. Accessed July 10, 2022. https://blog.doximity.com/articles/doximity-dialer-now-free-for-all-u-s-pharmacists-and-pharmacy-students