Does an Encounter with the Ambulatory Clinical Pharmacist in the Transitional Setting Play a Role in Clinic Attendance and Patient Engagement

Abstract Background Patient engagement is an important aspect in improving patient outcomes. However, there is a paucity of literature regarding patient engagement in a non-research healthcare setting. Patient engagement has several definitions making it challenging to assess, but attendance to initial primary care provider (PCP) visits is an important aspect of patient engagement. The effect of ambulatory clinical pharmacist interventions on clinic attendance and patient engagement has never been addressed in the literature. Objective The objective of this study was to assess if improved patient engagement, defined as attendance to an initial PCP visit, was associated with differences in services provided or pharmacist participation during post-discharge clinic appointments. Practice Description The site of this study was the Johns Hopkins After Care Clinic (JHACC), an interdisciplinary post discharge, safety net clinic in Baltimore, Maryland. Practice innovation Through an interdisciplinary healthcare team including pharmacists, patients received comprehensive care to assist with post-acute disease state management and transitions of care. Evaluation Methods Initial PCP visit attendance after a post-acute visit in a high risk population was evaluated for service delivery factors that differed between groups that attended and did not attend the initial PCP visit. Descriptive statistics and chi-square tests were utilized for analysis. Results Patients were significantly more likely to engage in primary care when clinical pharmacy specialists participated in their JHACC appointment (p=0.02). Medication education and disease state counseling improved initial PCP visit attendance, both of which are key pharmacist activities. Conclusion This study suggests ambulatory clinical pharmacy specialists' roles in an interdisciplinary clinic model correlates with increased attendance to initial PCP visits, a surrogate for patient engagement. Disease state education and medication education are both important activities in improving this measure, however, additional research is necessary to determine specific pharmacist interventions associated with patient engagement. As research in patient engagement continues, positive effects of pharmacist involvement in this area could support their value in ambulatory care services.