The Care Partner Clinic Addresses Common Barriers to Care

Zac Donehue, PharmD, the director of Care Partner Operations at Allegheny Health Network, Pittsburgh, Pennsylvania, and David Jordan, PharmD, a clinical pharmacy specialist at Allegheny Health Network, join Pharmacy Times to discuss the Network’s new Care Partner Clinic (CPC), a pharmacist-run ambulatory clinic that focuses on optimizing patient health, especially the health of patients with chronic diseases, from the cost and clinical perspective. They dive into unmet patient needs, medication management, and the impact of the pharmacist on patient outcomes.

PT Staff: What is the Care Partner Clinic (CPC) at West Penn Hospital?

Zac Donehue, PharmD: CPC is a pharmacist-run ambulatory clinic. We focus on medication related problems and support. So we support patients with 2 different programs, a comprehensive medication management (CMM) and medication therapy management. (MTM) focused on patient medication problems, access, and affordability. So we work closely with patients and providers to optimize medication therapy and medications and therapy from both a clinical and cost perspective, supporting 2 separate demographics, community patients and our employee base here at Allegheny Health Network (AHN).

PT Staff: What are the unmet needs of patients with chronic health conditions and how do pharmacists at this clinic help patients meet them?

David Jordan, PharmD: The 3 that I can think of would be medication education, affordability, and access. Our pharmacists have dedicated time to help patients truly understand the why and how behind their medications. We help them understand why their regimens are necessary, and we take the time to explain the benefits of taking their medicines on a consistent and regular basis.

We are also able to help patients with access to their medications, providing them through our integrated pharmacy here at Allegheny Health Network (AHN). If we identify an issue, or like a medication that is high cost, we help patients explore options such as coupon drug manufacturer programs, or even work with their providers to find a cost-effective alternative. Specifically in our program that we offer, we're able to take advantage and utilize 340b pricing of medications when it's appropriate to help reduce the burden of cost and overall improve the adherence rates of patients. We've also partnered with AHN financial assistance to provide support to the indigent patient population as well.

PT Staff: Does the role and services at the CPC look different than what might be done at a traditional pharmacy?

Zac Donehue, PharmD: Pharmacists here at Care Partner are dedicated and focused on medication therapy management and comprehensive medication management. So we have the benefit of an integrated pharmacy. So our retail team and our community team is able to fill prescriptions for patients. But here at CPC, we're able to focus on those clinical outcomes, focus on education and spend a significant amount of time actually talking with patients and helping them with the things they need. So we focus on reviewing access medication, compliance, adherence costs, understanding what's going on with them, listening to their concerns in some of our concerns, as well, and discussing some of our concerns so that we can identify what are next steps, how can we help you what we what can we do different to support you? We focus on uncontrolled disease states diabetes, hypertension, for some of the examples, and we work with those patients on a more frequent basis to help them to achieve their goals.

PT Staff: How do pharmacists approach medication adjustments at the clinic? You mentioned a lot of its uncontrolled disease states, and those must be much harder to have to toggle with figuring out the right thing.

David Jordan, PharmD: we approach it 1 of 2 ways, Erin. The first way is through our medication management (MTM) process. So in that process, we are meeting with patients twice a year and really focusing in on doing comprehensive medication review, evaluating medication profiles on a cost [or] clinical level. And if we do identify different issues, we are reaching out to their physicians to make recommendations, either from a cost or clinical perspective to optimize care. For our comprehensive medication management (CMM) phase of the Care Partner Clinic (CPC), we actually utilize a collaborative practice agreement to really maximize pharmacists’ interaction.

We do work with the provider at times through that, but we do utilize a collaborative practice agreement to make adjustments when we have patients that have uncontrolled disease states like high blood pressure, diabetes, etc…

PT Staff: when you use the appointment-based model, are patient outcomes reflected in the new model?”

Zac Donehue, PharmD: Absolutely. Our patients come and see us and they know that they're going to come and see us on a routine basis. So they come in here and they have questions ready (they go retail pharmacist on a more routine basis, but they recognize).

“Hey, I had a question, but I didn't have time to ask [the retail pharmacist] that day. These schedules…are these appointments scheduled ahead of time?” And, “Hey, I'm going to come and see David on the 14th at 2:00, and David knows what's going on with me, so I'm going to ask him XYZ questions and I know he's going to help me get to the bottom of it.”

The number of times that we sit down with somebody and recognize they're not using their inhaler correctly, or they're overusing their inhaler, or they're not injecting their insulin correctly. You always go into an appointment with a patient and have a plan, but they always seem to take that plan and you recognize that there's other things that you need to address.

PT Staff: Why are pharmacists’ good sources for providing specialized care and access to innovative therapies?

David Jordan, PharmD: Pharmacists are often considered the medication experts as part of the healthcare management team. Studies have shown that patients have very high level of trust in their pharmacist because they are very accessible at times. With our detailed understanding of medications, we are able to work with patients closely to really help them optimize their medication therapy pharmacist are able to stay up to date through various platforms, different continuing educations, programming, and other methods to kind of stay up to date with all the innovative therapies that are coming out.

The other great skill that pharmacists have is drug information. So, although we may not know the answer off the top of our head, we have a wide variety of research resources available for us to kind of look into and find the answer very timely for patients when they have specific questions about new drugs, new therapies, etc...

PT Staff: I just want to open the floor to either of you if you have anything else that you would like to add?

Zac Donehue: We help to manage chronic disease states, and, to David’s [point], he said it really well, but pharmacists have shown the impact that they can make and that's what the team and the pharmacist do here on a daily basis; it may be the littlest of things, but patients are appreciative. And I really think that we make a huge impact on the lives of our patients.