Assessing the structure and process for providing pharmaceutical care in Veterans Affairs medical centers

Sarah J. Billups, Gary Okano, Daniel C Malone, Barry L. Carter, Robert Valuck, Debra J. Barnette, Charles D. Sintek

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The structure and process used in providing pharmaceutical care to ambulatory care patients at nine Veterans Affairs medical centers (VAMCs) were studied. Institutions participating in the IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) study were selected. To assess the level of pharmaceutical care services provided to ambulatory care patients, 10 critical domains were identified. Six instruments with questions related to each domain were then designed, including a clinical pharmacist survey and an outpatient pharmacist survey. Each center was assessed through three surveys and an onsite visit. The investigators used both direct observation and a consensus approach to score the level of ambulatory care pharmaceutical services provided. The clinics in which IMPROVE study patients would be seen were run by pharmacists (33%), physicians (44%), and multidisciplinary teams (22%). Of the 51 clinical pharmacists surveyed, 23 (45%) had prescribing authority via protocols, 14 (28%) had unrestricted prescribing privileges, and 14 did not have prescribing authority. The sites varied greatly in referral patterns, methods of identifying patients, and whether patient visits were scheduled or on a walk-in basis. There was a strong correlation between observed activities by clinical pharmacists and their self-reports and between observed activities by outpatient pharmacists and their self-reports. Activities reported by clinical pharmacists were moderately but not significantly correlated with consensus scores, and activities reported by out patient pharmacists were poorly correlated with consensus scores. The structure and process for providing pharmaceutical care to ambulatory care patients at VAMCs were evaluated with surveys, direct observation, and a consensus-based scoring system.

Original languageEnglish (US)
Pages (from-to)29-39
Number of pages11
JournalAmerican Journal of Health-System Pharmacy
Volume57
Issue number1
StatePublished - Jan 1 2000

Fingerprint

Pharmaceutical Services
Veterans
Pharmacists
Ambulatory Care
Self Report
Outpatients
Observation
Managed Care Programs
Referral and Consultation
Research Personnel
Physicians
Surveys and Questionnaires

Keywords

  • Administration
  • Ambulatory care
  • Clinical pharmacists
  • Pharmaceutical care
  • Pharmaceutical services
  • Pharmacists, institutional
  • Pharmacy, institutional
  • Prescribing
  • Veterans Affairs

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Leadership and Management

Cite this

Billups, S. J., Okano, G., Malone, D. C., Carter, B. L., Valuck, R., Barnette, D. J., & Sintek, C. D. (2000). Assessing the structure and process for providing pharmaceutical care in Veterans Affairs medical centers. American Journal of Health-System Pharmacy, 57(1), 29-39.

Assessing the structure and process for providing pharmaceutical care in Veterans Affairs medical centers. / Billups, Sarah J.; Okano, Gary; Malone, Daniel C; Carter, Barry L.; Valuck, Robert; Barnette, Debra J.; Sintek, Charles D.

In: American Journal of Health-System Pharmacy, Vol. 57, No. 1, 01.01.2000, p. 29-39.

Research output: Contribution to journalArticle

Billups, SJ, Okano, G, Malone, DC, Carter, BL, Valuck, R, Barnette, DJ & Sintek, CD 2000, 'Assessing the structure and process for providing pharmaceutical care in Veterans Affairs medical centers', American Journal of Health-System Pharmacy, vol. 57, no. 1, pp. 29-39.
Billups, Sarah J. ; Okano, Gary ; Malone, Daniel C ; Carter, Barry L. ; Valuck, Robert ; Barnette, Debra J. ; Sintek, Charles D. / Assessing the structure and process for providing pharmaceutical care in Veterans Affairs medical centers. In: American Journal of Health-System Pharmacy. 2000 ; Vol. 57, No. 1. pp. 29-39.
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