Measuring the impact of integrating post-graduate year two ambulatory care pharmacy residents into specialty clinics

Background: It is well established that integration of a pharmacist into specialty clinics increases access to medication, improves patient adherence and decreases financial burden on patients. As specialty clinics and the prescribing of specialty medications continues to exponentially grow, it is critical for pharmacy residents to be provided learning opportunities within these settings to maximize pharmacy services as well as to educate future pharmacists in this field. The University of Louisville Hospital is an academic medical center that currently trains two post-graduate year two (PGY-2) ambulatory care pharmacy residents annually. Aims: To measure the impact of utilizing PGY-2 ambulatory care pharmacy residents on increasing coverage and provider satisfaction in specialty clinics. Additionally, to evaluate the ability of the learning experience in meeting the residents’ educational objectives. Methods: PGY-2 residents were trained to provide ambulatory care pharmacy services in the Hepatitis C and Multiple Sclerosis (MS) Clinics. They then provided those services with peripheral support from a preceptor over a 6 month period. Outcomes collected to determine the impact of PGY-2 residents included hours of clinic coverage provided, number of patients served, number of patients that discontinued treatment and provider satisfaction with pharmacy services. To demonstrate the meaningfulness of this learning experience, the educational objectives met as defined by the American Society of Health System Pharmacists (ASHP) residency standards will be reported. Results: Over 6 months, pharmacist coverage was expanded by 104 hours in the Hepatitis C Clinic and 84 hours in the MS Clinic through utilization of PGY-2 residents. The total number of patients served during those hours was 114 in Hepatitis C and 102 in MS. During this 6 month period, only three patients discontinued hepatitis C treatment before completing therapy and two patients discontinued therapy in the MS clinic due to medication related issues. Of the providers surveyed, 100% were satisfied with the pharmacy services provided and agreed that the pharmacist took prompt action to resolve their needs and/or concerns. ASHP educational objectives met through this learning experience include R1.1.3, R1.1.4, R1.1.6, R1.1.7, R2.1.2, R3.3.1 and R3.3.2. Conclusions: These results and observations show that patients, providers and PGY-2 ambulatory care residents all benefit from integration of PGY-2 residents into the specialty clinic setting.