title: Impact of health disparities on staff workload in pharmacist-managed anticoagulation clinics.
abstract: OBJECTIVE
  Pharmacists' provision of services unrelated to anticoagulant therapy at an anticoagulation clinic in an area of prevalent health disparities (health status differences between minority and nonminority populations) was evaluated.
  
  
  CONCLUSIONS
  A prospective cohort study was conducted to compare the frequency and types of additional services (i.e., services unrelated to anticoagulation) provided by pharmacists during an eight-week period at an urban clinic serving a primarily minority and socioeconomically disadvantaged patient population (clinic A) and a suburban clinic serving a primarily nonminority and affluent population (clinic B). Over the study period, additional services were provided during 42% of all patient visits (n = 444) at clinic A and 8% of all visits (n = 443) at clinic B. The most commonly provided additional services involved nonanticoagulation-related medical problems, which were addressed during about 9% of visits at clinic A and 3% of visits at clinic B; other additional services included setting up appointments, arranging transportation, and providing refills of nonanticoagulant medications. Missed appointments, early or late arrivals, and walk-in appointments were much more common at clinic A. The average daily pharmacist-staffing requirement was 3.8 hours higher at clinic A; over the entire study period, clinic A required a total of about 60 more staffed hours than clinic B.
  
  
  CONCLUSIONS
  Pharmacists practicing in an anticoagulation clinic serving an area of prevalent health disparities frequently spent a substantial amount of time addressing medical problems and administrative tasks unrelated to anticoagulation therapy.
authors.affiliation: Edward Hines, Jr. VA Hospital, Hines, IL 60141, USA. mmeade11@gmail.com
authors.forename: Michele
authors.initials: M
authors.lastname: Meade
authors.forename: Jill
authors.initials: J
authors.lastname: Borchert
authors.forename: Brooke
authors.initials: B
authors.lastname: Griffin
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Kliethermes
authors.forename: Kathy
authors.initials: K
authors.lastname: Komperda
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration; D000925:Anticoagulants / Q000008:administration & dosage; D002641:Chicago; D015331:Cohort Studies; D054624:Health Status Disparities; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D019036:Suburban Health Services; D013997:Time Factors; D019037:Urban Health Services; D000078329:Workforce; D016526:Workload
chemical_list: D000925:Anticoagulants