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Abstract
The Southern California region Kaiser Permanente Medical Care Program, which serves
2.2 million patients, and the University of Southern California School of Pharmacy
have designed and implemented a patient consultation study to determine the cost-effectiveness
of three different approaches to providing pharmacist consultation to outpatients.
This paper describes the development and implementation of these three models. A total
of 107 pharmacies (approximately 600 pharmacists) participated in the study and were
assigned to provide one of the models of patient consultation, designated the Kaiser
Permanente (KP) model, the state model, and the control model. The KP model (20 pharmacies)
provided targeted pharmaceutical care services to high-risk patients based on drug
use. The state model (67 pharmacies) provided California-mandated patient consultation
to patients with new or changed prescriptions, instructions for use, relevant warnings
and precautions, storage requirements, and the importance of compliance. The control
model (20 pharmacies) provided consultation when deemed necessary by the pharmacist
and provided care similar to that provided before mandatory consultation in California.
The KP and state models used the same pharmacist/technician/clerk resources, but the
control pharmacies limited personnel resources to those existing before the mandatory
consultation law was passed in California. The paper describes the KP model in detail
and provides a literature-based rationale for targeting particular high-risk patients
for expanded services. The paper also describes the training process, gives an example
of a high-risk patient intervention, provides information on documenting pharmacist
interventions in all models, and explains the method used for monitoring implementation
of the models.
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© 1995 Published by Elsevier Inc.
