Development of a Community-Wide Primary Care Pharmacy Program
Burnis D. Breland, M.S., Pharm.D., FASHP
and Debbie Nowlin, R.Ph.
Columbus Regional Healthcare System
Although extensive pharmacy services are provided to patients
in hospitals and health systems, outside the hospital, many
individuals do not have access to pharmaceutical care or essential
pharmaceuticals. A hospital pharmacy program can demonstrate
community leadership by developing primary care programs that
enable all patients of the community to have access to pharmaceuticals
and pharmaceutical care.
The pharmacy department of the Columbus Regional Medical Center
(Columbus, Georgia) developed a community-wide primary care
pharmacy program to assure that all residents of the Columbus
community had access to pharmaceuticals and pharmaceutical
care. This primary care pharmacy program was developed and
implemented over three years through partnerships with health
providers in the community and by obtaining federal, state,
and local funding to support the program. The pharmacy department
established relationships with other area health care providers,
including establishing a contractual relationship to provide
pharmacy services for the district health department.
Primary care pharmacy clinics were established in outpatient
centers of the medical center and in the local health department.
After obtaining federal approval and a federal grant to provide
clinical pharmacy services to a community health center (CHC)
network, the medical center contracted to provide clinical
pharmacy services to area CDC patients. Clinical pharmacists
who are employees of the medical center, practice in outpatient
pharmacy clinics in various facilities throughout the community,
including the health department, community health centers,
and outpatient clinics of the hospital.
Pharmaceuticals are provided to program patients from outpatient
pharmacies of the health system. Program funds are available
to cover the cost of medications not covered by insurance
or other programs. Pharmacists also provide services to area
shelters for the homeless and at an assisted living center
for mentally ill, impoverished patients. Establishment of
this primary care pharmacy program by the hospital pharmacy
department has helped lead expansion of services by the hospital
into various areas of the community and the surrounding region.
The program has demonstrated significant clinical benefits
to patients. Clinical outcomes of program patients are being
assessed and initial results with glucose control in diabetics
and blood pressure control in hypertensive patients are evidence
of the clinical success of the program. The acceptance and
feedback from physicians, nurses, and community leaders has
been very positive. The program demonstrates good stewardship
of scarce resources for indigent patients and it serves as
a model for collaboration between a hospital and other community
health care providers. The program also demonstrates how a
hospital pharmacy program can provide leadership within the
community that improves access to pharmaceutical care for
all residents of the region.