Evaluation of Provider Acceptance of Pharmacist Recommendations in a High User Patient Population.

Abstract

To compare the acceptance rate of pharmacist recommendations in an interdisciplinary team for patients interviewed by the pharmacist versus those assessed by chart review. Retrospective chart review. Interdisciplinary consultative team in an outpatient setting as part of a large academic health system provided care for "high utilizer" patients. Sixty-five patients at moderate to high risk of hospitalization who completed their first appointment with the team between March 1, 2019, and December 30, 2019. Most patients were 65 years of age or older and all had Medicare insurance. A pharmacist completed a chart review for all patients. A cohort of patients were also interviewed. Recommendations were recorded in the electronic medical record, discussed with the team, and forwarded to the patient's primary care provider. A total of 253 recommendations were made by pharmacists, with a significantly higher acceptance rate for patients who completed an interview with the pharmacist (40.7% vs. 28.4%; P = 0.046). Patientspecific factors resulting in higher acceptance rates in the interview group included age younger than 65 years (P = 0.013), 10 to 19 medications (P = 0.004), and mental health diagnosis (P = 0.02). The addition of an interview to chart review allowed pharmacists to make recommendations that were more likely to be accepted and therefore more clinically impactful.