A Descriptive Study of a Clinical Pharmacist's Role in the Outpatient Pulmonary Hypertension Clinic in the United States (CliPR-PH)

BACKGROUNDPulmonary arterial hypertension (PAH) is a rare disease affecting the heart and lungs. Median survival was 2.8 years historically, but prognosis improved with the advances of PAH therapy. It is currently not standard of care for clinical pharmacists to be a part of the interdisciplinary care team in outpatient PH clinics to help manage patients drug regimens, and there is limited literature that has explored the impact of clinical pharmacists on patient-related processes and outcomes. The goal of the CliPR-PH study is to characterize the activities of the clinical pharmacist as a member of the interdisciplinary team. METHODSCliPR-PH was a retrospective, descriptive, single-center cohort study of patients [≥] 18 years, diagnosed with pulmonary hypertension, and managed by a clinical pharmacist practicing under a collaborative practice agreement between January 1, 2018 and July 31, 2020. Patients were excluded from the study if they were not on any PAH medications at the time of pharmacist encounter. RESULTSSixty patients were included in the analysis and 331 clinical pharmacist interventions were documented over the study period. Interventions were regarding selexipag [88 (26.6%)], sildenafil [74 (22.4%)], tadalafil [46 (13.9%)], prior authorization (PA) completions [127 (38.4%), PA troubleshooting [43 (13.0%)], and Other [49 (14.8%)]. CONCLUSIONClinical pharmacists can play an important role in closely monitoring patients during the medication titration phase and ensure prior authorizations are approved in a timely manner as part of the interdisciplinary team in the outpatient PH clinic setting using a collaborative practice model approach. Clinical PerspectiveWhat is new? There are currently no studies in the United States that asses a clinical pharmacists role on the interdisciplinary team as part of a collaborative practice agreement in the outpatient pulmonary hypertension (PH) clinic. What are the clinical implications? Integrating a clinical pharmacist on the medical team in an outpatient PH clinic setting allows them to closely monitor patients who are titrating selexipag, manage adverse events (AEs) that occur during the titration phase, and ensure medications requiring prior authorizations are approved in a timely manner.