Implementing Pharmacist-Led Patient Home Visits

Abstract

Introduction Patients with chronic diseases such as hypertension and diabetes often experience difficulties managing complex medication regimens. A promising method for identifying and addressing medication-related problems is pharmacist provision of patient home visits. Pharmacist home visits could alleviate the burden on both patients and providers for the purposes of maintenance medication and goal-achievement assessment. Methods A pharmacist home visit program was developed utilizing social workers to identify patients who would most benefit from a pharmacist home visit. The two pharmacists met with these patients in their homes to evaluate their current medication regimens, adherence, medical condition status, and potential drug-related problems (DRPs). Upon conclusion of the home visit, the pharmacists provided a summary of findings and proposed solutions for identified drug related problems to the patient's primary care provider. Results Fourteen patients participated in pharmacist-provided home visits. During these home visits, 98 unique DRPs were identified. Drug-related problems were grouped into four categories: adherence (n=26, 27%), effectiveness (n=25, 26%), indication (n=24, 24%), and safety (n=23, 23%). Between the initial visit and the final visit, there was a resolution of 25 (26%) drug related problems. Conclusion This project demonstrated a novel referral pathway for identifying patients to participate in pharmacist-led home visits. By providing patient home visits, pharmacists were able to identify and resolve some drug-related problems, but many problems remain unresolved due, in large part, to lack of provider engagement.