Prioritization of patients for comprehensive medication review by a clinical pharmacist in family medicine

Background: this pilot study describes and evaluates the clinical pharmacy priority (cp2) score. we hypothesize that patients with high cp2 scores are more likely to receive a medication recommendation after comprehensive medication review (cmr) than patients with lower scores. prioritization of patients for cmr by a clinical pharmacist in family medicine could enhance the provision of interprofessional care within the patient-centered medical home. methods: the cp2 score was developed collaboratively by the research team and is derived from 11 patient-specific factors extracted from the electronic health record. to evaluate the utility of the score,cmr was performed prospectively by a clinical pharmacist for patients with appointments between october 1 and december 31,2012,at 2 university of colorado family medicine clinics. results: cmr was performed for 1107 patient appointments. of these,101 were identified as having received a medication recommendation from the clinical pharmacist. for patients with a cp2 score of 0 to 2,2 of 588 charts (0.3%) reviewed received a recommendation (level 1). the proportion increased to 37 of 358 (10.3%) for scores of 3 to 7 (level 2),40 of 119 (33.6%) for scores of 8 to 10 (level 3),and 22 of 42 (52.4%) for scores of ≥11 (level 4). compared with cp2 scores in level 1,patient appointments were more likely to receive a medication recommendation after cmr in level 2 (relative risk [rr],30.4; 95% confidence interval [ci],7.4-125.3),in level 3 (rr,98.8; 95% ci,24.2-403.3),and in level 4 (rr,154; 95% ci,37.5-632.8). conclusions: patients with higher cp2 scores were more likely to receive a medication recommendation after cmr by a clinical pharmacist than patients with lower scores. the cp2 score could be used by clinical pharmacists in family medicine to enhance the efficient and effective delivery of interprofessional care. © 2015,american board of family medicine. all rights reserved.