Pharmacists Can Perform Consultations at Federally Qualified Health Centers

Federally Qualified Health Centers (FQHCs) focus on providing services at outpatient clinics, typically for underserved patient populations.¹

Examples of FQHCs include community health centers, health care at centers for unhoused individuals, migrant health centers, and public housing primary-care centers. They receive funding from the Health Resources and Services Administration (HRSA). In 2020, HRSA awarded grants to 1375 FQHCs.¹ Pharmacists can play a critical role in providing medication therapy management (MTM) services at FQHCs to improve health outcomes (Figure^2,3).

FQHCs, Pharmacist MTM Involvement

Pharmacists can provide care to patients with acute and chronic health conditions. Additionally, pharmacists can provide these services through an interdisciplinary approach as part of a medical team or with community pharmacy partnerships. These MTM services can be provided through a variety of approaches, such as by phone, electronically, face to face, or via telehealth.² Patient consultations may involve the pharmacist with other clinicians at a single visit. Another approach involves a separate consultation with the pharmacist.²

Evidence shows that pharmacist involvement in FQHCs can reduce levels of blood pressure (BP), cholesterol, hemoglobin A (HbA_1C), and triglycerides.² Patient care involves MTM that includes pharmacotherapy management and screenings. One study evaluated MTM in 10 Ohio FQHCs, performed by pharmacists, for managing HbA_1C levels and BP.³ Patients were eligible for the study if they were aged 18 to 75 years with a diagnosis of diabetes, hypertension, or both. The study results showed that of the 1692 participants, 60% achieved an HbA_1C level of less than 9%.

Additionally, 79% of patients achieved a BP level less than 140/90 mm Hg.³ This demonstrates the vital role that pharmacists play in chronic disease state management.

Behavioral health is another critical area in which pharmacists are involved at FQHCs. Anxiety and depression are generally the most common mental health conditions that pharmacists manage at FQHCs.²

Pharmacist MTM of depression has resulted in faster appointments for medication evaluation.² Pharmacists also provide valuable MTM services for patients with respiratory conditions, and involvement with spirometry testing is a critical role.² Pharmacists can perform patient assessments, interpret findings, and provide medication recommendations. Evidence shows that pharmacists provide enhanced patient care for individuals with chronic obstructive pulmonary disease.

Pain management to improve opioid prescribing and monitoring is another key area for pharmacist involvement at FQHCs. Pharmacist-led education classes provide information about the types of pain and treatment options.² Pharmacists can also provide a variety of preventive care services such as colonoscopy preparation group education programs.² Additionally, pharmacists can administer immunizations and provide screenings. Other services include fall prevention medication consultations, hormonal contraceptive prescribing, and smoking cessation education.² Pharmacists are also critical for ensuring that patients have access to specialty medications for managing conditions, such as hepatitis C virus (HCV) and HIV.

Pharmacist involvement in managing patients with HCV and HIV has resulted in improved medication adherence and follow-up through multidisciplinary care.²

Medication reconciliation is another significant role that pharmacists can fulfill as drug experts.

Evidence shows that pharmacists can improve the accuracy of medication lists in electronic health records.² Pharmacists can identify discrepancies that include duplication of therapy and missing medications. Additionally, pharmacists can perform medication reviews to assess for drug interactions and provide clinical recommendations. These clinical interventions canprevent adverse drug events.²

References

1. Federally Qualified Health Center. US Department of Health & Human Services. January 2017. Accessed January 11, 2023. https://static1.squarespace.com/static/53023f77e4b0f0275ec6224a/t/5a29875a0d92972420c91437/1512671067129/fqhcfactsheet.pdf

2. Rodis JL, Irwin AN, Valentino AS, Erdmann AM. Pharmacist care in Federally Qualified Health Centers: a narrative review. J Am Coll Clin Pharm. 2022;5(12):1297-1306. doi:10.1002;jac5.1696

3. Rodis JL, Capesius TR, Rainey JT, Awad MH, Fox CH. Pharmacists in Federally Qualified Health Centers: models of care to improve chronic disease. Prev Chronic Dis. 2019;16:E153. doi:10.5888/pcd16.190163

About the Author

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