title: Provider Perception of Pharmacy Services in the Patient-Centered Medical Home.
abstract: BACKGROUND
  Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile.
  
  
  OBJECTIVE
  To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation.
  
  
  METHODS
  A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group.
  
  
  RESULTS
  The survey response rate was 78%. Top-tier clinical services were identified as medication counseling, reconciliation, adherence assessment, polypharmacy assessment, and drug information. Formulary review was the only top-tier cost- or access-related service. Top-tier educational services included new black-boxed warnings, drug market withdrawals, and new drug reviews. Ninety-one percent of providers were comfortable referring to a pharmacist for diabetes medication selection and dose titration, but no other disease state eclipsed 75%. More than twice as many providers found the pharmacy service to be very or extremely valuable when the pharmacist is physically located in the office versus virtual interactions (70% vs 34%).
  
  
  CONCLUSIONS
  Top-tier clinical, cost/access, and educational services considered worthwhile by providers in a PCMH have been identified. In addition to these services, when developing or evaluating a pharmacy service, special attention should be paid to provider preference for physical location in the office and perceived barriers to the pharmacist availability, concern over complex disease management competency and patient confusion as to the role of the pharmacist.
authors.affiliation: 1 School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Albanese
authors.affiliation: 2 Buffalo Medical Group, State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA.|3 Excellus Blue Cross Blue Shield, Rochester, NY, USA.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Pignato
authors.affiliation: 1 School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Scott V
authors.initials: SV
authors.lastname: Monte
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*; D010593:Pharmaceutical Services / Q000592:standards*; D010595:Pharmacists / Q000592:standards*; D024382:Professional Role
keywords: ambulatory care; patient-centered medical home; pharmacy services; provider; survey