In an effort to bolster front-line medical care and improve health in small towns and rural areas across the state, a team of University of Iowa College of Pharmacy researchers has created a virtual, web-based service that allows doctors and nurses in distant locations to consult on a variety of medical issues with clinical pharmacy experts on the Iowa City campus.
As part of the service—called Centralized Healthcare Solutions (CHS)—university pharmacists and pharmacy students also regularly talk with patients via telephone or virtually through a web site to ensure they are keeping up with their medications, making healthy lifestyle choices, and staying in contact with their primary care provider.
In an early test of the service, UI pharmacy researchers selected 12 Iowa primary care offices without an on-site pharmacist and randomly selected six of those offices to receive additional pharmacy monitoring. The multi-year study showed that patients in offices with the additional monitoring had better health outcomes than those without, including improved diabetes management and an overall reduction in risk for potentially deadly cardiovascular disease.
The team also conducted another study with larger health care centers, including many in other states, and found that even when clinical pharmacists are part of the on-site medical team, the added back-up from UI clinical pharmacists resulted in improved patient care and disease management.
“When people think of pharmacists, they often think of the pharmacists they see at the pharmacy,” says Christopher Parker, a pharmacy specialist with the UI College of Pharmacy and executive director of operations for CHS. “But pharmacists are key members of the health care team and can provide much more than expertise about medications. We can work with patients to help them perform home monitoring for conditions such as diabetes or high blood pressure, and we can give them strategies to better manage their conditions.”
For doctors, the addition of a virtual pharmacist means they are able to attend to patients with more serious or complex medical conditions. And for on-site clinical pharmacists, the benefit is having more time to talk with patients about medication side-effects and to help find the best drug therapy possible. Parker says these benefits and others were documented in the CHS research.
“CHS is able to provide a tailor-made medication regimen for each patient,” he says. “We can look at dosing requirements for specific conditions that doctors may not be aware of, and we can provide ongoing feedback about patient progress. We provide doctors with patient-reported home monitoring results for conditions like high blood pressure and diabetes and provide clinical recommendations to go along with those results.”
UI pharmacy research shows that, in a majority of cases, about 89 percent of the time, doctors agreed with patient recommendations made by CHS clinical pharmacists, including those to increase medication doses, change medications, provide flu or pneumonia vaccines, and prescribe colorectal cancer screenings.
“Our team has a common vision of using technological innovation to improve the level of care provided to patients in a wide variety of settings,” says Parker. “We started CHS in Iowa to serve Iowans and we’ve had very positive results. Now we’re looking to serve an even broader patient population.”