title: Perceived successes and challenges of clinical pharmacist practitioners in North Carolina.
abstract: OBJECTIVE
  To describe the successes and challenges reported by current (active) and formerly practicing (inactive) CPPs and to determine the reasons why inactive CPPs discontinued advanced practice.
  
  
  METHODS
  A sampling frame, consisting of all active and inactive CPPs, was obtained from the North Carolina Boards of Medicine and Pharmacy. An electronic survey was sent to 84 active and 32 inactive CPPs. Respondents were queried regarding qualifications, experience, and practice characteristics, perceived successes, and perceived challenges.
  
  
  RESULTS
  54 active and 22 inactive CPPs responded. Among active CPPs, 28 (51.9%) reported improved patient care outcomes and 27 (50.0%) reported an expanded scope of practice. Regarding challenges, 30 (55.6%) identified billing for services and 19 (35.2%) noted reimbursement through third parties. Among inactive CPPs, 14 (63.6%) experienced improved patient care outcomes and 11 (50.0%) said their licensure created a practice model for learners. Billing (54.5%) and reimbursement (31.8%) were the top challenges experienced by inactive CPPs. A total of 12 inactive CPPs (54.5%) discontinued CPP licensure because it was not a requirement of their current position. Three (13.6%) discontinued because of insurmountable challenges that made it difficult to continue practice.
  
  
  CONCLUSIONS
  Although CPPs held a perception of improved patient care outcomes, billing for services and obtaining reimbursement were reported as the most prevalent challenges and may have played a major role in CPPs becoming inactive.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Hale
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Murawski
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ives
mesh_terms: D006801:Humans; D017146:Models, Organizational; D009657:North Carolina; D005791:Patient Care / Q000191:economics / Q000379:methods; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration*; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D024382:Professional Role; D012051:Reimbursement Mechanisms / Q000191:economics*; D011795:Surveys and Questionnaires