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

Columbus, GA

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.