Evaluation of a specialty pharmacy health coaching program

Background: Fairview Specialty Pharmacy provides comprehensive therapy management (TM) for patients, yet some patients require additional social, physical, and psychological support that may be unmet by a pharmacist or nurse. To address complex patient needs and remotely improve social determinants of health, a health coach is employed. The projected benefits of a health coaching program for patients include providing holistic support for health and mental well-being, identifying and overcoming barriers to healthy coping, and identifying additional resources for support. Aims: Goals of this study were to determine the impact of a health coach in patients who receive specialty pharmacy services as measured by number of referrals to this program, patient satisfaction and perceived impact on health, and impact on patient depression scores. Methods: Health coaching services were offered to patients during initial TM call or when a trigger was identified, such as emotional distress, new chronic illness diagnosis, life transition, coping issues, stress management, end of life, advanced care planning, or family concerns. Initial outreach health coach call to the patient provided program overview, confirmed interest, determined focus area (emotional/spiritual needs, loss/grief, lifestyle changes, or stress management), encouraged goal setting, and documented baseline depression score using the Patient Health Questionnaire (PHQ-9). Follow-up calls between the patient and health coach were focused on patient goals; referrals to additional services were documented. At the end of the third call, the PHQ-9 was given and a satisfaction survey was mailed to the patient. Program impact was determined based on satisfaction surveys, referrals, and the change in PHQ-9 after the third call. Results: 623 health coaching assessments were completed in 82 patients (April 2016-January 2019). The most common coaching focus (46% of patients) was combined emotional/spiritual and loss/grief. PHQ-9 was assessed in 54 patients at baseline and session 3; improvement occurred in 30 of the 54 patients (56%). In patients with baseline moderate to severe depression, 70% of patients experienced decreased depression. Anonymous patient experience survey (n = 21) revealed that 86% of patients in this program strongly agreed or agreed that their physical health and 95% strongly agreed or agreed that their mental health was positively impacted by working with the health coach. All patients (100%) strongly agreed or agreed that they were satisfied with the Fairview Specialty Pharmacy health coaching program. The health coach referred 37 patients to additional services, including support groups, social workers, case managers, physicians, psychiatrists, and hospice or advance care planning. Conclusions: The specialty pharmacy health coaching program was impactful, as measured by high patient satisfaction, positive patient perception of program impact on physical and mental health, improved patient depression scores, and referrals to other resources.