Evaluating types of pharmacist interventions performed during implementation of a new payer model using professional service fees

Abstract

Objective: The study objectives are to quantify, categorize, and evaluate interventions pharmacists make during the dispensing process to ensure safe and effective medication use, while being paid a professional fee in addition to regular dispensing fees for performing a point-of-care prospective drug utilization review (DUR). Method(s): This will be a retrospective study conducted at an independent pharmacy. This pharmacy site collaborated with a local payer to initiate a pilot project to pay the pharmacy a professional service fee per prescription for conducting a thorough, in-depth, prospective DUR. There are potentially 600 patients enrolled in this specific health insurance plan, who fill prescriptions at this pharmacy location. Data from April 1, 2014 to October 31, 2014 will be extracted from the pharmacy's clinical software system. Data collection will include drug therapy problems (DTPs) identified, pharmacists' actions to resolve these DTPs, and the consequences of the pharmacists' intervention. In addition, descriptive variables will be collected for patients: age, gender, and number of medications. DTPs will be categorized as: need for additional therapy, unnecessary drug therapy, wrong drug, dose too low, dose too high, adverse drug reaction, and poor adherence. Pharmacists' actions will be categorized as: patient education, communication with prescriber, recommending action to patient, patient monitoring, and referral to another provider. The consequences of the pharmacists' interventions will be categorized as: making a change in drug therapy, adding a drug, stopping a drug, increasing patient adherence to drug therapy, and decreasing patient overuse of drug therapy. Frequencies and descriptive statistics will be tabulated for each measure. Result(s): Research in progress. Implications: Reforming current reimbursement models may help community pharmacies shift their focus to delivering quality health care and away from increasing prescription volume.