EFFECTIVENESS OF AN AMBULATORY CARE CLINICAL PHARMACIST - A CONTROLLED TRIAL

OBJECTIVE: To compare two general medicine clinics to determine the ef fectiveness of an ambulatory care clinical pharmacist in assisting rec ognition of drug therapy problems for physicians and decreasing drug t herapy costs. DESIGN: Controlled trial. SETTING: Two general medicine ambulatory care clinics associated with a large, tertiary-care teachin g hospital. PATIENTS: Those with scheduled and completed appointments in the clinics during the two-week study period. METHODS: Medication p rofiles of patients attending clinic A (pharmacist intervention) and c linic B (no pharmacist intervention) were reviewed by the pharmacist p rior to clinic appointments. Potential drug therapy problems were iden tified at each clinic, but interventions were performed only at clinic A. Postappointment audits determined the number of recommendations im plemented at clinic A versus the number of drug therapy problems (pote ntial interventions) recognized and addressed by clinic B physicians i ndependently of pharmacist intervention. Potential and actual savings were extrapolated to one year from the two-week study period. RESULTS: Implementation of interventions at clinic A was greater than at clini c B (p<0.001). Drug therapy cost savings at clinic A were annualized t o yield $185 per intervention. Potential cost savings of $176 724, or four times the pharmacist salary costs, is projected. CONCLUSIONS: An ambulatory care pharmacist is effective in identifying drug therapy pr oblems, resulting in significant cost savings to the institution.