The Pharmacist's Role in Biologic Management for IBD in a Health System-Integrated Practice Model

Objectives: At the University of Illinois Hospital and Health Sciences System (UI Health), patients with chronic gastrointestinal conditions receive outpatient care through a clinical practice model integrated with a pharmacist working both in the clinic and specialty pharmacy call center. The pharmacist performs routine efficacy and safety monitoring, provides patient education, ensures medication insurance coverage and acquisition, and optimizes adherence. The objective of this paper was to describe the pharmacist's multiple roles within the gastroenterology clinic, with a focus on self-injectable biologic therapies used for patients with inflammatory bowel disease. Study Design: This is a descriptive paper with adherence data. Methods: A retrospective chart review was conducted from January 1, 2008, to December 31, 2013 to assess the pharmacist's impact on medication adherence. Patients 18 years or older initiated on self-injectable biologic therapy with a minimum of 4 consecutive prescription refills at UI Health pharmacy for each calendar year were included. Refill history data was collected. Adherence was determined through medication possession ratio (MPR) and data was analyzed using SAS software. Results: The MPR for patients who receive prescriptions for self-injectable biologics at UI Health averaged 90%. In addition to optimizing adherence rates, the pharmacist provides patient education, assists with acquisition of biologics, and provides close monitoring for the efficacy and safety of biologic therapy. Conclusions: Within the integrated clinical practice model, the pharmacist provides comprehensive optimal patient care. Meaningful clinical outcomes data are warranted in future studies to further evaluate the pharmacist's impact.