Establishing an on-site pharmacy in a community health center to help indigent patients access medications and to improve care.
OBJECTIVE
To describe the establishment of an on-site pharmacy in a community health center (CHC) to improve access to medications for indigent patients, the implementation of pharmaceutical care programs and clinical pharmacy services to improve patient care and therapeutic outcomes, and the development of an ambulatory care site for training pharmacy students.


METHODS
Partnership Health Center (PHC), a federally funded CHC in Missoula, Mont.


METHODS
Establishment of an on-site pharmacy and strategies for accessing medications for indigent patients, including participation in the U.S. Public Health Service pricing program, pharmaceutical manufacturers' assistance programs, and drug sampling, are described. The clinical pharmacy, disease management, and pharmaceutical care programs developed at the site to improve medication use and therapeutic outcomes are discussed. Development of an ambulatory care clerkship site at the CHC for training University of Montana pharmacy students is reviewed.


METHODS
Partnership between PHC and the University of Montana School of Pharmacy and Allied Health Sciences (SPAHS) to establish an on-site pharmacy to help medically indigent patients access medications and to improve care.


METHODS
Programs to help indigent patients access, adhere, and appropriately use needed medications while decreasing clinic expenditures for medications.


METHODS
Number of prescriptions dispensed per month, clinic expenditures on medications per month, and number of clinical services and pharmaceutical care programs developed.


RESULTS
Between November 1, 1999, and April 30, 2000, the average number of prescriptions filled for PHC clients increased from 219/month to 838/month and the average expenditure per prescription decreased from $16.55/month to $0.51/month. A pharmacist-assisted refill program was implemented. Programs in diabetes, hypertension, dyslipidemia, asthma, anticoagulation, and peptic ulcer disease were developed.


CONCLUSIONS
Establishing an on-site pharmacy in a CHC in collaboration with a school of pharmacy significantly improved indigent patients' access to medications while decreasing clinic expenditures. Pharmaceutical care programs improved therapeutic outcomes, and clinical pharmacy services complemented the clinical activities of other health care providers in managing chronic diseases and resolving drug-related problems. The CHC provided an excellent setting for training pharmacy students in ambulatory care.
Dent
Larry A
LA
Department of Pharmacy Practice, School of Pharmacy and Allied Health Sciences, University of Montana, Missoula 59812-1522, USA. ldent@selway.umt.edu
Stratton
Timothy P
TP
Cochran
Gayle A
GA
D003151:Community Health Centers / Q000191:economics / Q000458:organization & administration*; D004345:Drug Industry; D006297:Health Services Accessibility / Q000458:organization & administration*; D008910:Minnesota; D010594:Pharmacies / Q000191:economics / Q000458:organization & administration*; D017664:Uncompensated Care / Q000191:economics*; D014481:United States; D014492:United States Public Health Service