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Introduction Traditionally, clinical pharmacists have been employed in the primary care setting to help manage chronic disease states, such as diabetes and hypertension. Although the benefits of pharmacists managing chronic conditions have been extensively published, published data for clinical pharmacist mental health services in primary care is limited to Veterans Affairs populations. This article describes a practice model in which pharmacists are providing psychiatric medication management and consultation in a federally qualified health center. Methods A period of 1 year from the psychiatric pharmacy service was analyzed from April 1, 2017, to March 31, 2018. Reports were generated that included information about psychiatric pharmacy consults, 1-on-1 psychiatric pharmacy visits, and psychotropic medication prescribing/dispensing trends. Each consult was further reviewed for additional details, including patient characteristics, medications prescribed, psychiatric diagnoses involved, and actions taken. Results A review of this pharmacy service showed significant pharmacist involvement in psychiatric medication consults and 1-on-1 visits. Common disease states consulted on were depressive disorders, anxiety disorders, and neurologic disorders, which reflects psychiatric disease states commonly seen in primary care practice. Provider satisfaction survey results showed that the service was valued and that providers felt their comfort in prescribing psychotropic medications improved due to the service. Discussion The service described here exemplifies the potential for pharmacists in the ambulatory care setting to expand beyond the traditional chronic disease state management. It also speaks to a potential role for psychiatric pharmacists in the primary care setting.

Background : There is a shortage of primary care medical providers, particularly in rural communities and communities of racial and ethnic minority groups. Clinical pharmacists can help fill gaps in care among these vulnerable populations. Obj ective : To identify characteristics of ambulatory care pharmacists that pursue and maintain employment within underserved areas. Methods : An original survey was distributed nationwide to ambulatory care clinical pharmacists in underserved settings. Respon dent characteristics were analyzed using descriptive statistics. Results : Of the 111 completed surveys, a majority of respondents were White, non - Hispanic, female, with English as their only spoken language. A majority of pharmacists completed a clinical experience or specialized training focused on underserved care prior to their position. The top three motivators for pharmacists accepting their clinical position as well as staying at their job were pas sion for caring for underserved populations, the pres ence of a faculty appointment, or the freedom and flexibility of advanced clinical roles. Conclusions : With a large majority of our respondents identifying as White and unilingual, there remains a large opportunity to increase diversity in the clinical ph armacy ambulatory care workforce caring for underserved populations. There is an observed correlation between early experiential or specialized training in underserved care and pharmacists pursuing employment in the se areas. Thus, one potential long - term s trategy to diversify and grow the ambulatory care clinical pharmacist workforce in underserved settings is for clinical practice sites to partner with colleges of pharmacy to recruit and maintain quality individuals who can meet the needs of diverse patien t populations as well as expand student and resident training opportunities in underserved settings.

Introduction To evaluate the design of an interprofessional introductory pharmacy practice experience (IP-IPPE) designed to integrate third-year pharmacy students in patient care workflow under the direct supervision of non-pharmacist practitioners in a federally qualified health center. Methods Data was gathered to evaluate the success of the IP-IPPE from the students', providers', and clinic's perspectives. Preceptors completed a mixed-methods survey to determine satisfaction and value of the IP-IPPE. Students completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) post-IP-IPPE to assess change in interprofessional outcomes. Student performance and competency demonstration was assessed using a modified interprofessional professional assessment scoring tool. Finally, a retrospective patient chart review was conducted to determine student value to the clinic. Results During a 12-week period at the studied clinic, 32 students were supervised by eight primary care providers (PCPs) and cared for 516 patients. Six providers (75%) endorsed students' ability to provide value-added interventions during clinical care. A chart review of 200 patient records indicated students provided medication education to 12% of patients engaged with, in addition to other contributions. Students' ICCAS self-assessments indicated significant improvement across all outcomes following the IP-IPPE. Qualitative provider responses indicated meaningful investment into the IP-IPPE and appreciation for pharmacy student's collaboration during patient care. Conclusion All 32 students in this study were able to earn the trust of their assigned PCP preceptors. The IP-IPPE design created value for learners, patients, and providers.

Purpose Expansion of clinical pharmacist positions through sustainable funding is described. Summary The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences was awarded a 2-year program grant to establish an integrated clinical pharmacy program for underserved residents in family health centers in northeastern Colorado. The grant enabled the hiring of 2 bilingual, full-time, board-certified, postgraduate year 2–trained clinical pharmacists to initiate comprehensive clinical pharmacy services. Clinical pharmacy services for diabetes, hypertension, and dyslipidemia management were provided during direct patient care visits using collaborative drug therapy management protocols to facilitate comprehensive medication management. Initial visits lasted 1 hour, and follow-up visits lasted 30 minutes. In addition, clinical pharmacists provided point-of-care consultations for patients seeing other healthcare providers. All patient encounters and consultations were documented in the electronic health record. Success of the clinical pharmacy program was evaluated based on the achievement of goal blood pressure values, glycosylated hemoglobin values, and low-density-lipoprotein cholesterol levels. Pharmacists’ involvement in patient care activities led to improvements in all of these clinical outcomes. This coincided with unique funding opportunities with regional accountable care organizations that sought to demonstrate improved patient care in an expansion population. As a result, 2 grant-funded clinical pharmacist positions in 2 community health clinics were converted into 4 faculty positions in 5 community health centers funded by regional accountable care organizations. Conclusion Collaboration with accountable care organizations resulted in the successful funding of ambulatory care clinical pharmacy services. These services resulted in improved chronic disease control and provider satisfaction.

Background: Diabetes and its complications disproportionately affect Hispanic patients, many of whom receive care at federally qualified health centers (FQHCs) and prefer to receive care in a language other than English. There is little published data on clinical pharmacy diabetes services in this setting. Objective: This study aims to measure the impact of a Collaborative Drug Therapy Management–driven bilingual clinical pharmacy service on diabetes outcomes in an FQHC that primarily serves Hispanic patients, many of whom prefer to receive their care in Spanish. Methods: Patients were included if they had a diagnosis of diabetes and initial pharmacy visit between July 1, 2015, and March 31, 2016. Individual charts were analyzed for changes in hemoglobin A1C (A1C), changes in blood pressure (BP), number of visits, ethnicity, and primary language preference. Data for these patients were collected through September 30, 2016. Results: The median preintervention A1C was 10.5%; the median postintervention A1C was 9.1% (n = 211; P < 0.0001). Statistically significant BP reductions were also found in patients with uncontrolled hypertension at baseline. There were no statistically significant differences in A1C improvement based on ethnicity or language preference. Conclusion and Relevance: Patients with diabetes managed by Spanish-speaking clinical pharmacists had significant improvement in their A1C. Hispanic and non-Hispanic patients, as well as patients who preferred their care in Spanish, had similar improvements in A1C. Clinical pharmacists who speak Spanish may help reduce diabetes-related health disparities in this population. This collaborative care model could be replicated at other institutions to help underserved patients.

Background and purpose The primary objective of this study was to assess changes in pharmacy students’ attitudes and perceptions toward providing care to underserved populations after a six-week clinical experience within a Federally Qualified Health Center (FQHC) clinic. Educational activity and setting A pre-post survey design was utilized to evaluate third- and fourth-year pharmacy students’ attitudes and perceptions before and after a six-week clinical rotation providing direct patient care to underserved patients in FQHC clinics. Results were collected via self-administered online surveys that collected information on participants' (1) demographics, (2) past experiences interacting with underserved populations, (3) type of clinical activities completed during the rotation, and (4) personal opinions and perceptions of providing care to underserved populations. Findings Responses to seven of the 18 attitudinal questions showed a statistically significant positive change from baseline, with three questions being related to educational satisfaction. Changes in attitudes for questions related to domains of personal impact and perceptions/barriers were also significant. Discussion/summary Clinical rotations within an FQHC clinic can positively impact pharmacy students’ attitudes towards underserved populations. If more students are exposed to direct patient care with underserved populations throughout their experiential training, the number of graduating student pharmacists that explore job opportunities within underserved areas may increase. Clinical rotations within an FQHC clinic can positively impact pharmacy students’ attitudes towards underserved populations. If more students are exposed to direct patient care with underserved populations throughout their experiential training, the number of graduating student pharmacists that explore job opportunities within underserved areas may increase.