Pharmacists play a critical role in healthcare as the primary medication safety expert. As patient complexity increases, so do their medication needs, making pharmacy services more essential than ever. Working collaboratively with physicians and other healthcare providers, pharmacists serve as vital extenders of the care team, ensuring safe, effective, and coordinated medication management across the continuum of care.1-4 The growing need for pharmacy expertise is particularly evident in specialized clinical settings, where complex medication regimens and evolving treatment protocols demand close collaboration among healthcare professionals. One such clinical area is neurology, where the integration of pharmacists into outpatient clinics has demonstrated measurable benefits for patients, providers, and health systems alike.
A recent article published in the Journal of the American Pharmacists Association examined the impact of integrating clinical pharmacists in neurology clinics at an academic medical center that manages patients with neurological conditions that often require complex medication regimens including costly specialty medications.5 The complexity of these specialty medications often extends to their prior authorizations as payers have stiff requirements before pharmacotherapy initiation. The main goal of this research study was to determine whether having pharmacists embedded within neuroimmunology and neuromuscular clinics would improve patient access to prescribed medications. To accomplish this goal, the authors conducted a retrospective chart review and compared outcomes before and after pharmacists were added to the care team. The pre-integration group included patients from early 2019, while the post-integration group reflected data from early 2022. Each group included 101 patients who had been newly prescribed neurology medications.
Significant improvements were demonstrated in access to pharmacotherapy following pharmacist integration. In the 2022 group, nearly 87% of patients received their originally prescribed medication within 90 days, compared to about 72% in the 2019 group. When alternative therapies were included, access increased to 90% post-integration, compared to 73% pre-integration. These differences were statistically significant and point to the positive impact pharmacists had on helping patients start treatment in a timely manner. Beyond improving access, pharmacists were actively involved in more than 60% of the post-integration patient cases, contributing an average of nearly five interventions per patient. These responsibilities included handling prior authorizations, counseling patients about their complex medications, coordinating vaccinations and lab monitoring, and serving as liaisons between patients, providers, and payers.5
The study suggests that the addition of clinical pharmacists to neurology care teams not only improves the speed and rate at which patients begin needed therapies but also enhances the overall coordination of care. These findings also highlight the unique value pharmacists bring to interdisciplinary care teams, especially in managing patients who rely on complex, high-cost therapies that require significant patient education and monitoring. It should be noted that the resistance of third-party payers to directly compensate pharmacists’ clinical services remains an obstacle that limits the scalability of these models despite clear evidence of their value.6-8 As healthcare systems evolve, addressing this barrier is key to maximizing pharmacists’ impact in easing provider burdens and improving patient care.
Author Bio:
Kyle M. Sousa, PhD
Dr. Sousa is a Professor of Pharmaceutical Sciences and currently serves as the Dean of the School of Pharmacy. His research interests include pharmacy workforce sustainability and approaches towards enhancing professional advocacy.
References:
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- Howard M, Trim K, Woodward C, et al. Collaboration between community pharmacist and family physicians: lessons learning from the seniors medication assessment research trial. J Am Pharm Assoc. 2003;43:566–72.
- McDonough RP, Doucette WR. Developing collaborative working relationships between pharmacists and physicians. J Am Pharm Assoc. 2003;41:682–92.
- Ernst M, Brandt KB. Evaluation of 4 years of clinical pharmacist anticoagulation care management in a rural private physicians office. J Am Pharm Assoc. 2003; 43:630–6.
- Anderson, B, Snider, MJ, Hansen, M, et. al. Benefit of clinical pharmacists in neurology clinics at an academic medical center. J Am Pharm Assoc. 2024; 64: 492-498.
- Elliot, AN, Buzzard, LN, Villa, KR, et. al. Physicians' and advanced practice providers' perceptions of the impact of embedded clinical pharmacists on the work environment in ambulatory care clinics. Am J Health Syst Pharm. 2023; 80(4): 200-206.
- Rottman, EI, Cote, J, Thomas, S, et. al. Use of protocol-driven medication refills by pharmacists decreases rheumatologist in-basket work and improves rheumatologist satisfaction. BMJ Open Qual. 2022. 11(1):1-7.
- Gadd, S, Cox, N, Slager, S, et. al. Assessing the impact of a payor-funded embedded clinical pharmacist on patient and provider satisfaction in a private primary care practice. Am J Health Syst Pharm. 2023; 80(12): 742-749.