Development of a pharmacy referral protocol to enhance interprofessional services in a university-affiliated dental medicine clinic

Abstract Objective To discuss the process of developing pharmacy consult services within a university-affiliated dental clinic. Secondary objectives are to describe the frequency of pharmacy consults provided when comparing the initial to the modified protocol and interventions, over time. Setting A university-affiliated student–driven dental medicine clinic in the Midwest. Practice description The dental clinic consists of third- and fourth-year dental students who provide dental services and are supervised by dental faculty. Pharmacy consults are prompted due to patient criteria met on the protocol, patient-specific factors, drug information, or other reasons. Pharmacists are present to provide consults directly with dental students or patients. Practice innovation Since October 2013, pharmacy services have been implemented into a dental clinic. A protocol is established to identify dental patients with high risk medications and medical conditions that may interfere with dental treatment. The initial protocol has been modified to include additional high-risk medications and conditions that the pharmacy team was being consulted for outside the protocol criteria. Evaluation A retrospective chart review was completed to evaluate the frequency of use of the original pharmacy protocol and the interventions provided. After the protocol was modified to include additional high-risk criteria, a second chart review was completed to assess changes in frequency of protocol use and interventions provided. Results Pharmacists undergo extensive self-learning to understand the dental-related concerns of the high-risk criteria as well as the dental workflow. The original pharmacy protocol accounted for 42.3% (n = 113) of the overall pharmacy consults (n = 267). After protocol modifications, utilization increased to 76.4% (n = 352, total n = 461). Conclusion Pharmacists are successfully integrated into a dental medicine clinic to provide services to enhance dental patient care. The approximate 30% increase in the use of the pharmacy consult protocol demonstrated that the modified version was more effective.