Boston Clinical Pharmacy Practice Network: A HRSA Demonstration Project

Goal

To establish the Boston Clinical Pharmacy Practice Network to develop cost effective clinical pharmacy programs in community health centers serving underserved populations. To incorporate pharmacy practice and education into the primary care teams of health centers to promote improved health outcomes of patients.

Assumptions

A. Financial affordability of prescription drugs is a major barrier to access for uninsured and low income patients of health centers which significantly impacts treatment outcomes and management of chronic diseases among underserved populations.

B. "Drug misadventure," a term which covers a broad array of adverse or negative experiences associated with prescribed poly pharmacy drug taking activities, among urban elderly and minority populations.

C. The integration of clinical pharmacy services, the responsible provision of drug therapy to achieve improved quality of life outcomes of life of patients and reduce costs in health care delivery.

D. A partnership between the School of Pharmacy and community health centers offers the greatest potential for conducting community relevant research and evaluation to inform community practice and impact racial/ethnic disparities in health.

Accomplishments

* The CCHERS partnership has successfully established models of interdisciplinary
clinical faculty practices and educational experiences involving medicine, nursing,
pharmacy, physical therapy professionals in community health centers.

* Bouve College of Health Sciences School of Pharmacy houses the National Education Research Center for Outcomes Assessment, a HRSA designated national demonstration center with extensive experience in the design, implementation, and evaluation of clinical interventions to measure the impact on health related quality of life outcomes of patients.

* CCHERS has facilitated the development of community derived and directed research through the Boston Community Practice Research Collaborative (BCPRC), a practice based research network of "academic community health centers, " engaged in health services and clinical research focused on eliminating continuing health disparities among racial/ethnic populations.

* CCHERS and the School of Pharmacy have developed a variety of models of clinical pharmacy practice in health centers including services to frail elders in an adult day health program; a Center of Excellence in Asthma Management; and an interdisciplinary urgent care team.

Policy Objectives

Promote development of comprehensive pharmacy practices in community health centers to increase access to clinical pharmacy services and affordable pharmaceuticals for underserved populations.

* Establish role of clinical pharmacist in community health centers as part of primary care teams to improve drug related processes of care.

* Increase access to affordable prescription drugs through outreach and enrollment of eligible patients in available drug benefit programs.

* Develop formulary and manage in house inventory of pharmaceutical samples and negotiate relationships with local pharmacies interested in the 340B PHS purchasing program.

Establish cost effective pharmacy programs for community health centers to implement 340B PHS regulations.

* Assess economic feasibility of alternative models for delivery of pharmacy services, i.e., on site pharmacy or contracted pharmacy, for implementation of 340B regulations by community health centers.

* Support legislative policy efforts and financial proposals to establish vehicles for acquisition of low cost prescription drugs, including, but not limited to the state's uncompensated care pool, Citizen's Energy Corporation Cooperative Drug Purchasing Plan, and other bulk purchasing programs.

* Develop business plans for two health centers to develop models, i.e., one in-house and one contracted pharmacy.

Assess the clinical and financial impact of integrating pharmacy services into the community center service delivery model

* Develop data systems and evaluation procedures for documenting changes in patient/provider interaction, patient compliance and health care status to determine efficacy of pharmacy services and pharmaceutical care provided.

* Introduce cost effective pharmacy services and pharmaceutical care to reduce consumption of health care resources.