Implementation of a community-based pharmacist-run attention deficit hyperactivity disorder clinic in a college health center

• Main Authors: El-Kurdi, R. (Author), Marciniak, M.W (Author), Pohl, L. (Author), Rhodes, L.A (Author), Sauls, A. (Author), Selinger, R. (Author)
• Format: Article
• Language: English
• Published: Elsevier B.V. 2021
• Subjects: adult; adverse drug reaction; ambulatory care; Ambulatory Care; Ambulatory Care Facilities; amphetamine derivative; Article; attention deficit disorder; Attention Deficit Disorder with Hyperactivity; blood pressure monitoring; central stimulant agent; chi square test; clinical pharmacist; collaborative care team; comparative study; controlled study; data analysis software; drug induced disease; Drug-Related Side Effects and Adverse Reactions; electronic health record; elevated blood pressure; evaluation study; female; follow up; health care policy; health care quality; health center; human; Humans; long acting drug; major clinical study; male; medication compliance; medication therapy management; methylphenidate; mood change; outpatient department; patient monitoring; pharmacist; Pharmacists; protocol compliance; psychiatrist; resident; retrospective study; short acting drug; substance use; tachycardia; young adult
• Online Access: View Fulltext in Publisher

 Background: Published evidence is lacking to describe the pharmacist's role in medication management within an attention deficit hyperactivity disorder (ADHD) specialty clinic. Objectives: The objectives were (1) to measure the growth of an ADHD clinic in a college health center after the integration of clinical pharmacists and (2) to evaluate provider adherence to clinic policies and procedures before and after pharmacist integration. Practice description: In 2017, a pharmacist-run ADHD clinic was established at a college campus. Practice innovation: Pharmacists conducted collaborative initial visits with psychiatrists and independently provided follow-up appointments for patients with ADHD. Evaluation methods: Data were extracted from the electronic health record for patients aged 18 years or older with an ADHD diagnosis who completed a medication evaluation or medication follow-up visit from July 1, 2016 to June 30, 2019. Data were excluded if it was for another visit type, was a non-ADHD clinic provider visit, or if the visit note was classified. Data before the pharmacist integration (July 1, 2016–June 30, 2017) were compared with data after the pharmacist integration (July 1, 2017–June 30, 2019). Chi-square tests of independence evaluated differences in blood pressure monitoring, heart rate monitoring, and stimulant medication contract signature between psychiatrist- and pharmacist-run appointments. Results: Pharmacist presence in the ADHD clinic increased from 0 full-time equivalent (FTE) to 0.2 FTE over 3 years. The number of appointments increased by 1003% (from 26 to 287). Compared with psychiatrist-run appointments, pharmacist-run appointments were more adherent to monitoring blood pressure (11% vs. 77%, P < 0.001) and heart rate (6% vs. 75%, P < 0.001), as well as clinic policy requiring a patient's signature on a stimulant medication contract (64% vs. 75%, P = 0.019). Conclusion: Pharmacists can assist psychiatrists in medication management of ADHD in the college health setting. A pharmacist-psychiatrist collaboration increased quality of care and monitoring of medication adverse effects. © 2021 American Pharmacists Association®