title: Impact of pharmacist-operated general medicine chronic care refill clinics on practitioner time and quality of care.
abstract: OBJECTIVE
  To assess the impact of pharmacist-operated refill clinics on practitioner (physician/physician assistant) time. Secondary objectives included assessment of disease state control, drug acquisition costs, and human resource allocation.
  
  
  METHODS
  The study ran from October 1, 1993 through January 31, 1994. At one clinic the pharmacist performed chart review only and did not see the patient. At the second site the pharmacist also interviewed the patient. The pharmacist used no treatment algorithms. Practitioner and pharmacist time before and after implementation of the refill clinics was measured on 3 consecutive days of normal clinic operation.
  
  
  METHODS
  Two state correctional facilities.
  
  
  METHODS
  The study population consisted of patients receiving chronic care who were observed during regular clinic hours.
  
  
  METHODS
  We evaluated pharmacist and practitioner time before and after pharmacist involvement. Hypertension was the only disease state yielding sufficient numbers for statistical analysis. We used a two-tailed paired t-test with the priori level set at 0.05. We also evaluated the number of patients with disease state control before and after clinic implementation, drug acquisition costs, and human resource allocation.
  
  
  RESULTS
  The refill clinic pharmacist reduced practitioner time commitment in both clinics. The greatest impact on practitioner time was found in the interview clinic. Quality of care was maintained equally between the two clinics, with a positive impact on human resource allocation.
  
  
  CONCLUSIONS
  In the managed care environment, pharmacist-run refill clinics can decrease practitioner time commitment allowing reallocation of human resources while maintaining current quality of care.
authors.affiliation: Texas Department of Criminal Justice-Institutional Division (TDCJ-ID) Huntsville, USA.
authors.forename: I B
authors.initials: IB
authors.lastname: Cassidy
authors.forename: M R
authors.initials: MR
authors.lastname: Keith
authors.forename: E L
authors.initials: EL
authors.lastname: Coffey
authors.forename: M A
authors.initials: MA
authors.lastname: Noyes
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics / Q000503:physiopathology; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000191:economics; D010595:Pharmacists / Q000706:statistics & numerical data*; D010820:Physicians; D011787:Quality of Health Care; D013781:Texas; D013997:Time Factors
chemical_list: D004364:Pharmaceutical Preparations