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University of Wisconsin-Madison

Kreling and Chewning develop process for physician referrals to pharmacists

Pharmacists have many potential roles and contributions in direct patient care beyond dispensing. Some hospitals, health systems, and clinics integrate pharmacists into care teams where physicians rely on pharmacists for therapeutic input and decision making and they refer patients to pharmacists for help in managing medications. In community settings, pharmacists have made patient services available but they sometimes face challenges with reception and acceptance. Physician referrals for community pharmacists to perform Medication Therapy Management (MTM) would greatly facilitate reaching patients who need these services. Physician legitimation through referral is central to move forward patient confidence in pharmacists’ MTM roles.

David Kreling and Betty Chewning, professors in the Social and Administrative Sciences in Pharmacy Division, have teamed with David Hahn, director of the Wisconsin Research and Education Network (WREN) in a project funded by the Community Pharmacy Foundation to develop processes for physicians to refer patients to pharmacists for medication management. The project builds on prior parallel surveys amongst the researchers’ respective pharmacy and physician practice based research networks (PEARL-RX and WREN), that identified interest in collaborating and medication management as a need of patients.

The project is being conducted with physician/pharmacist dyads in four cities, Dodgeville, La Crosse, Milwaukee, and Sun Prairie. In formative interviews with the dyads, what physicians mean by ‘medication management’ is clarified and crystallized into specific pharmacist services and activities for patient referral. Procedures and materials for referrals will be developed and revised with input from the physicians and pharmacists, followed by implementation and referral of eight patients by each physician. The referrals and pharmacist medication management activities for patients will be evaluated from the perspectives of the physicians, pharmacists, and patients, to give insight for how the services and referrals can be expanded to other physician and pharmacist practices.

With a better understanding of physician views of patients’ needs for help with managing their medications, targeted pharmacist services addressing those needs, and referral processes directing patients to them, pharmacists will be a more used resource and contributing integral member of the community-based care team for patients.