Impact of embedding a pharmacist in a dermatology clinic on outcomes in a specialty pharmacy.

Abstract

Specialty pharmacists in a health system can help streamline medication access for patients and provide clinical support to providers. The University of Louisville (UofL) Health - UofL Hospital postgraduate year 2 (PGY-2) ambulatory care pharmacy resident implemented a new service in the UofL Health dermatology clinic in October 2020, with the goal of providing multidisciplinary care and ultimately improving patient access to specialty dermatology medications. To describe the financial impact (dermatology prescription volume and return on investment for the UofL Hospital Specialty Pharmacy) and clinical impact (time to medication initiation, adherence, adverse events, quality of life, pharmacist interventions, and patient satisfaction) after the addition of a pharmacist to the UofL Health dermatology clinic. Before this new service, the dermatology clinic team lacked a pharmacist. A PGY-2 ambulatory care pharmacy resident spent 1 half day per week (4 hours) in the dermatology clinic from October 2020 to April 2021 and established a workflow assisting with medication selection, initiation, access, education, and monitoring. Data were collected by retrospective chart review for patients who were seen in the UofL Health dermatology clinic and filled a specialty dermatology medication with the UofL Hospital Specialty Pharmacy from October 15, 2019, to October 14,2021. There was a 28.87% increase in prescription volume of dermatology specialty medications sent to the UofL Hospital Specialty Pharmacy during the time period after the addition of the pharmacist (P= 0.023). The average time to initiation of medications was 13.6 days for the postintervention group and 21.3 days for the preintervention group. The addition of a pharmacist to the dermatology clinic enhanced the relationship between the providers and specialty pharmacy, leading to a positive impact on clinical and financial outcomes. Health-system specialty pharmacies can mimic this model to expand pharmacy services within dermatology.