title: Prioritization of patients for comprehensive medication review by a clinical pharmacist in family medicine.
abstract: BACKGROUND
  This pilot study describes and evaluates the clinical pharmacy priority (CP2) score. We hypothesize that patients with high CP2 scores are more likely to receive a medication recommendation after comprehensive medication review (CMR) than patients with lower scores. Prioritization of patients for CMR by a clinical pharmacist in family medicine could enhance the provision of interprofessional care within the patient-centered medical home.
  
  
  METHODS
  The CP2 score was developed collaboratively by the research team and is derived from 11 patient-specific factors extracted from the electronic health record. To evaluate the utility of the score, CMR was performed prospectively by a clinical pharmacist for patients with appointments between October 1 and December 31, 2012, at 2 University of Colorado family medicine clinics.
  
  
  RESULTS
  CMR was performed for 1107 patient appointments. Of these, 101 were identified as having received a medication recommendation from the clinical pharmacist. For patients with a CP2 score of 0 to 2, 2 of 588 charts (0.3%) reviewed received a recommendation (level 1). The proportion increased to 37 of 358 (10.3%) for scores of 3 to 7 (level 2), 40 of 119 (33.6%) for scores of 8 to 10 (level 3), and 22 of 42 (52.4%) for scores of ≥11 (level 4). Compared with CP2 scores in level 1, patient appointments were more likely to receive a medication recommendation after CMR in level 2 (relative risk [RR], 30.4; 95% confidence interval [CI], 7.4-125.3), in level 3 (RR, 98.8; 95% CI, 24.2-403.3), and in level 4 (RR, 154; 95% CI, 37.5-632.8).
  
  
  CONCLUSIONS
  Patients with higher CP2 scores were more likely to receive a medication recommendation after CMR by a clinical pharmacist than patients with lower scores. The CP2 score could be used by clinical pharmacists in family medicine to enhance the efficient and effective delivery of interprofessional care.
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP). joseph.vandegriend@ucdenver.edu.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Vande Griend
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP).
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Saseen
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP).
authors.forename: Debra
authors.initials: D
authors.lastname: Bislip
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP).
authors.forename: Caroline
authors.initials: C
authors.lastname: Emsermann
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP).
authors.forename: Colleen
authors.initials: C
authors.lastname: Conry
authors.affiliation: From the Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora (JPVG, JJS), and the Department of Family Medicine, University of Colorado School of Medicine, Aurora (JPVG, JJS, DB, CE, CC, WDP).
authors.forename: Wilson D
authors.initials: WD
authors.lastname: Pace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D010595:Pharmacists; D010865:Pilot Projects; D024382:Professional Role; D011446:Prospective Studies
keywords: Delivery of Health Care; Family Practice; Health Care Rationing; Medication Therapy Management