Implementation of a Pilot Pharmacist Testosterone Therapy Management Service. J Pharm Pract 2020 Oct;33(5):654-660
Date
02/23/2019Pubmed ID
30791810DOI
10.1177/0897190019830251Scopus ID
2-s2.0-85061974355 1 CitationAbstract
BACKGROUND: Recent literature findings suggest that opportunities exist to optimize testosterone replacement therapy management.
OBJECTIVE: To evaluate the impact of a pilot clinical pharmacist testosterone therapy management service in a Veterans Affairs primary care setting.
METHODS: A 6-month, single-clinic, prospective cohort quality improvement project included male patients with an active prescription for testosterone. Patients were excluded if they switched primary care providers or were managed by a specialty clinic. After diagnosis, primary care providers had the option of referring patients for clinical pharmacist testosterone replacement therapy management. The project investigated the impact of pharmacist management on adherence to guideline-defined baseline and therapeutic monitoring, prior authorization workload, time saved by primary care providers, and clinical pharmacist interventions.
RESULTS: Sixty patients split between pharmacist management (N = 35) and nonpharmacist management (N = 25) cohorts. Monitoring of baseline parameters was significantly improved with clinical pharmacist management (54% vs 20%, P = 0.0006). Improved baseline monitoring decreased prior authorization team workload as requests were approved on the first submission at a higher rate (100% vs 75.4%, P = 0.06). Pharmacist management increased therapeutic monitoring for assessing symptom improvement (96% vs 26%, P < 0.001), monitoring of testosterone levels (96% vs 61%, P = 0.003), and safety monitoring with complete blood counts (100% vs 83%, P = 0.04). A total of 42 pharmacist-patient encounters saved over 600 minutes of primary care provider time.
CONCLUSION: Clinical pharmacist involvement enhances therapeutic monitoring for male hypogonadism leaving room for expansion of clinical pharmacy services within testosterone replacement therapy management.
Author List
Nagy MW, Gruber S, McConnell MAuthor
Michael W. Nagy PharmD Assistant Professor in the School of Pharmacy Administration department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cohort StudiesHumans
Male
Pharmacists
Pharmacy Service, Hospital
Prospective Studies
Testosterone
