Rural health system administrator perspectives on pharmacists' role in collaborative drug therapy management

Background

Collaborative drug therapy modification (CDTM) authorizes adjustment of dosages, dosage schedules, and/or medications within a defined protocol under physician supervision within Georgia. Pharmacist-led collaborative drug therapy management positively impacts health outcomes leading to reduced health care expenditures. Less than 1% of Georgia pharmacists have a CDTM license.

Objective

The objective was to obtain feedback from rural primary health care system administrators to assist in increasing CDTM services and expand access to patient care services in Georgia.

Methods

An exploratory qualitative interview research design was utilized. Complete target population sampling was used to increase likelihood of data saturation. In January 2023, 7 health system administrators were interviewed regarding knowledge of pharmacists and pharmacist-led CDTM, as well as perceived benefits of and barriers to implementation of pharmacist-led CDTM. Interview responses were transcribed. A two-cycle inductive coding process utilizing constant comparison was employed to identify themes verified by analyst triangulation.

Results

Inconsistent understanding of pharmacist knowledge, skills, and abilities under CDTM by administrators was identified. Perceived benefits of pharmacist-led CDTM included (1) improved patient care, (2) increased value-based metrics, and (3) enhanced physician-pharmacist collaborations. Perceived barriers to the expansion of pharmacist services included concerns regarding (1) physician acceptance, (2) pharmacist knowledge and comfort, and (3) loss of revenue. Improving administrator and provider awareness of pharmacist abilities and providing evidence of benefit from similar services were identified by administrators as potential ways to encourage CDTM participation.

Conclusion

Health-system administrators are one of the key stakeholders in successful pharmacist-led CDTM implementation, but may have limited understanding of pharmacist knowledge, skills, and abilities under pharmacist-led CDTM. Improving their knowledge and understanding, as well as identifying and addressing their perceived benefits and barriers to implementing CDTM, may facilitate the expansion of pharmacist-led CDTM services, particularly in Georgia.