Pharmacist care plans and documentation of follow-up before the Iowa Pharmaceutical Case Management program.
OBJECTIVE
To document drug therapy problems and their causes and assess pharmacist follow-up of patients with identified drug therapy problems.


METHODS
Cross-sectional analysis.


METHODS
Iowa.


METHODS
160 pharmacists who submitted 754 pharmaceutical care plans in an effort to qualify for participation in the Iowa Pharmaceutical Case Management program.


METHODS
Care plans were assessed for drug therapy problems and causes and for documentation of pharmacist follow-up (actual, none, or intent to follow up).


RESULTS
Pharmacists documented a wide variety of drug therapy problems and causes, including adverse drug reactions (20.1% of care plans), need for additional drug therapy (18.9%), lack of patient adherence to therapy (16.3%), incorrect medication being prescribed (14.1%), and drug dose too high (10.0%). Pharmacist follow-up with patients was not optimal, with 31% of care plans providing documentation of actual follow-up. Another 42.2% of plans indicated that the pharmacist intended to contact the patient for follow-up but either did not do so or did not record the intervention. No actual follow-up or intent to follow up was recorded in 26.8% of care plans. Pharmacists practicing in independent pharmacies followed up with patients more frequently than those in other settings (36.4% of care plans, compared with 22.7%, 23.2%, and 28.4% for chain, clinic, and franchise pharmacies). Pharmacists were more likely to follow up when the identified problem involved drug safety rather than effectiveness (36.2% versus 28.3% of care plans).


CONCLUSIONS
Documentation of pharmacist follow-up with patients was less than optimal. In addition to identifying drug therapy problems and causes, pharmacists must complete the care continuum through documentation of patient monitoring and follow-up to transform the philosophy and vision of the pharmaceutical care concept into a practice of pharmacy recognized and rewarded by patients and payers.
Becker
CoraLynn
C
Department of Pharmacy, University of Kansas Medical Center, Kansas City, KS 66160, USA. cbecker@kumc.edu
Bjornson
Darrel C
DC
Kuhle
Julie W
JW
D019090:Case Management / Q000592:standards*; D003430:Cross-Sectional Studies; D004282:Documentation; D004358:Drug Therapy / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007484:Iowa; D008297:Male; D008875:Middle Aged; D010604:Pharmacy / Q000592:standards*