title: Defining and advancing ambulatory care pharmacy practice: it is time to lengthen our stride.
abstract: OBJECTIVE
  This paper reviews the basic tenets of ambulatory care pharmacy practice, including (1) the historical development of patient-centered care provided by pharmacists, (2) the need for and value of comprehensive medication management, (3) the education, training, and qualifications of pharmacists, and (4) demonstrated improvement in health and healthcare outcomes from pharmacists' services.
  
  
  CONCLUSIONS
  When ambulatory care pharmacists engage in patient care to their full capacity, physician time is saved, access to care is improved, and clinical and economic outcomes are enhanced. There is a need for ambulatory care pharmacists to work toward optimizing safe medication use and optimizing medication therapy for patients with diabetes, asthma, cardiovascular disease, and renal disease. Other opportunities for the development of ambulatory care pharmacy services exist in preventive care, precision therapeutics, medication therapy management, mitigation of healthcare disparities, and implementation of national healthcare reform. Interprofessional patient care teams should include ambulatory care pharmacists in patient-centered medical homes and accountable care organizations. Ambulatory care pharmacy practice would benefit by enhancing specialty residency training and by creating a residency/fellowship for advanced subspecialty clinical practice and research. Provider status is essential to recognize pharmacists as an integral part of the patient care team.
  
  
  CONCLUSIONS
  By assertively advancing ambulatory care practice, pharmacy will help achieve the national priorities of improving patient care, patient health, and affordability of care.
authors: Dennis K. Helling, Pharm.D., D.Sc., FCCP, FASHP, FAPhA, is Executive Director Emeritus, Pharmacy Operations and Therapeutics, Kaiser Permanente Colorado, and Clinical Professor, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora. Samuel G. Johnson, Pharm.D., FCCP, BCPS (AQ-Cardiology), is Clinical Pharmacy Specialist-Applied Pharmacogenomics, Kaiser Permanente Colorado, and Clinical Assistant Professor, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado. dennis.helling@gmail.com.
authors: Dennis K
authors: DK
authors: Helling
authors: Dennis K. Helling, Pharm.D., D.Sc., FCCP, FASHP, FAPhA, is Executive Director Emeritus, Pharmacy Operations and Therapeutics, Kaiser Permanente Colorado, and Clinical Professor, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora. Samuel G. Johnson, Pharm.D., FCCP, BCPS (AQ-Cardiology), is Clinical Pharmacy Specialist-Applied Pharmacogenomics, Kaiser Permanente Colorado, and Clinical Assistant Professor, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado.
authors: Samuel G
authors: SG
authors: Johnson
mesh_terms: D000553:Ambulatory Care; D006801:Humans; D054539:Medication Therapy Management; D010348:Patient Care Team; D018802:Patient-Centered Care; D010593:Pharmaceutical Services