Characteristics of ambulatory care clinics and pharmacists in Veterans Affairs medical centers: an update

Abstract

Purpose: The characteristics of ambulatory care pharmaceutical services and pharmacists in Veterans Affairs medical centers (VAMCs) were studied.

Methods: A descriptive survey comprised of multiple-choice and short-answer questions was developed to assess the characteristics of ambulatory care VAMCs and health care systems (HCSs), including pharmacist-managed clinics, clinics with pharmacist involvement, clinics without pharmacist involvement, group clinics, and residency programs. The survey, a letter explaining its purpose, instructions to complete it, and a link to the online questionnaire were sent electronically. Responses were recorded by means of an electronic survey tool, and the data were analyzed using descriptive statistics and compared with the results of a similar study conducted in 1998.

Results: A total of 69 of the 157 survey recipients completed the survey. Of the respondents from pharmacist-managed clinics, the most commonly reported specializations were anticoagulation (38), primary care and general medicine (37), and lipid management (25). Of the 37 facilities that reported having a pharmacist-managed primary care clinic, the mean +/- S.D. number of primary care clinics was 3.8 +/- 3.7 per facility (range, 1-16). Of the 38 facilities reporting a pharmacist-managed anticoagulation clinic, all of them allowed pharmacist prescribing privileges. A total of 35 of the responding facilities reported having clinics with pharmacist involvement. Of the 1344 pharmacists employed at the responding sites, 666 of them were devoted to providing ambulatory care services.

Conclusion: Compared with the original 1998 report, the number of pharmacists involved in ambulatory care in VAMC HCS facilities has increased as the scope and type of care provided have expanded. This trend is likely to continue for ambulatory care services in VAMC HCSs.