Pharmacist-led telehealth tobacco cessation services compared with usual care in a community health center.

BACKGROUND: Previous studies regarding tobacco cessation services (TCS) concluded that pharmacist interventions lead to higher or similar quit rates compared with usual care; however, little is known about patient satisfaction with these services. OBJECTIVES: This study assessed 30-day point prevalence abstinence and patient satisfaction of TCS provided by pharmacists compared with primary care providers (PCPs) in a community health center. Secondary objectives assessed the number of encounters and time spent counseling and medications prescribed at each visit. METHODS: Patients at the age of 18 years or older with tobacco use disorder and a new quit attempt were invited to complete a 9-question survey via e-mail, phone, and mail 7 months after their initial tobacco cessation visit. The survey assessed 30-day point prevalence abstinence and patient satisfaction. Chart reviews were conducted to assess time spent counseling and prescribing patterns. RESULTS: The response rate was 38.8% (50/129) overall, 43.9% in the pharmacist group and 36.3% in the PCP group. A 30-day point prevalence abstinence was reached by 22.2% (4/18) in the pharmacist group and 9.4% (3/32) in the PCP group (P = 0.23). Patient satisfaction was significantly higher in the pharmacist group with regard to discussion around medications used to quit smoking (100% vs. 65.6%, P = 0.004), understanding how to properly use the medications (100% vs. 62.5%, P = 0.002), identifying behavioral changes to assist with quitting (94.4% vs. 65.6%, P = 0.036), and frequent follow-up visits (83.3% vs. 46.9%, P = 0.016). Pharmacists spent more time counseling patients and were more likely to prescribe dual nicotine replacement therapy and prescription medications. CONCLUSIONS: There was not a statistically significant difference in abstinence rates, and patient satisfaction with TCS provided by pharmacists and PCPs was high. Pharmacists provide a more intensive service by spending more time counseling patients and providing more follow-ups and are more likely to diversify medications prescribed to quit smoking.

Implementation and use of an electronic health record in a charitable community pharmacy.

OBJECTIVES: To describe the implementation of enhanced health information technology (HIT), specifically an electronic health record (EHR), into the workflow of a charitable community pharmacy and to highlight the impact of the EHR on clinical service advancement, student and resident learning, research, and grant support for the pharmacy. SETTING: The Charitable Pharmacy of Central Ohio (CPCO) is a nonprofit community pharmacy that provides medications and pharmacy services for uninsured and underinsured patients. PRACTICE DESCRIPTION: CPCO has adopted a practice model in which patients discuss their medications and health conditions in a private counseling area with a pharmacist or pharmacy student. Counseling sessions incorporate point-of-care testing, medication therapy management, and community program referrals, with documentation of the visit in the patient's chart. PRACTICE INNOVATION: This article describes the implementation of a cloud-based EHR in a charitable community pharmacy. EVALUATION: The decision-making process for converting from a paper-based chart to an EHR is described. Feedback from stakeholders, discussions at staff meetings, and a quality improvement project led by 2 pharmacy residents helped to inform and improve the process. RESULTS: Implementation of an EHR has allowed CPCO to improve documentation of patient encounters and communicate more effectively and efficiently with other health care professionals. Student and resident learning has been enhanced, and reporting tools have facilitated additional opportunities for successful funding and more robust research. CONCLUSION: The use of an EHR at CPCO has provided opportunities to enhance patient care and improve other areas of practice. Community pharmacies should consider the utilization of HIT and EHRs to demonstrate the impact on patient care, elevate the standard of practice, and offer support for provider status.