How Clinical Pharmacists Work to Improve Drug Therapy for Our ACO Patients

| Posted On Aug 06, 2013 | By:

The Atrius Health groups have a team of clinical pharmacists working with our physicians, nurse practitioners, physician’s assistants, nurses and support staff to optimize the effectiveness, safety and cost of medication therapy for all patients – including Accountable Care Organization (ACO) patients.

Each of our clinical pharmacists has an advanced degree and ambulatory care clinical training/experience, and practices within our Internal Medicine and Family Medicine departments. Here, they participate in team meetings to develop specific care plans for our most medically vulnerable patients. They provide drug therapy recommendations that include simplifying patient’s medication regimens, identifying less costly medications for patients, adjusting drug doses to bring patients’ blood pressure, blood sugar or cholesterol under control, minimizing drug interactions and side effects, and reducing the risk of medication-related falls.

Clinical pharmacists are also consultants to clinicians and nurses who review the medications of ACO patients newly discharged from a hospital stay. When a patient’s medication list is unclear or problematic, clinical pharmacists are there to step in and research any problems or make suggestions for drug or dosage changes.

Throughout every day, clinical pharmacists are available to answer drug questions from clinicians, such as:

Questions can be simple and quick to answer, or take considerable research.

Later in 2013, we will be piloting an official referral service at several Atrius Health practices to allow patients with complex medication regimens (especially those with a recent hospitalization) to see a clinical pharmacist at no charge to optimize their drug therapy. A special focus of these visits will be on helping patients identify reasons for not regularly taking their medications as prescribed, and developing a plan to improve their medication adherence.

Atrius Health clinical pharmacists also develop and maintain many tools within our electronic medical record system that help clinicians with medication prescribing. They develop quick ways of prescribing the most appropriate drugs by disease state, preference lists of the most commonly prescribed medications with pre-entered directions and quantities, After-Visit-Summary medication education phrases to teach patients about new drugs prescribed for them during a clinician visit, and pop-up alerts that let clinicians know if a drug has a high copayment, requires prior authorization or is not covered by a patient’s insurance.

When important new clinical research is released or a Food & Drug Administration bulletin is issued that changes what we know about the safety of a particular medication, our clinical pharmacists quickly develop a consensus recommendations together with expert specialty clinicians within Atrius Health to provide guidance to all Atrius Health clinicians and patients. As is necessary, patients on affected medications are identified so that clinicians can communicate directly with them, and patients’ drug therapy can be adjusted.

Finally, clinical pharmacists provide education to clinicians about the newest medications or the latest national guidelines for the effective use of specific drugs to treat specific conditions. Formal presentations or informal one on one “academic detailing” allow our clinical pharmacists to get evidence-based information to our clinicians, arming them with the facts to counter often-misleading information on the Internet or from pharmaceutical manufacturer advertising to patients. Each of our internal medicine and family medicine clinicians works closely with his/her clinical pharmacist to provide affordable, high quality care to all of our patients.

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About Amy Vachon, PharmD

Amy Vachon, PharmD is Director of the Atrius Health Clinical Pharmacy Program and co-chair of the Atrius Health Pharmacy & Therapeutics Committee. She joined Harvard Vanguard in 1996 and has worked to grow the Clinical Pharmacy Program which provides services to patients at many of our Atrius Health locations. Prior to working at Atrius Health, Amy was the Assistant Director for Clinical Pharmacy Services at Beth Israel Hospital, and before that, she worked in the operating room at Tufts Medical Center as a Clinical Pharmacy Specialist in Anesthesia and Operating Room Pharmacy. Amy graduated with a Doctor of Pharmacy from the University of Michigan, and completed a residency in pharmacy practice at Tufts Medical Center in Boston. Amy is also passionate about creating the opportunity for work/life balance that allows every employee to be his or her best contributor to the workplace, and is the author, together with her husband, of Equally Shared Parenting: Rewriting the Rules for a New Generation of Parents (Perigee Penguin 2011). She’s the mother of two children and an avid amateur violinist in her spare time.

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