A single center, retrospective review of prescription volume, pharmacy staffing, and safety reports over a three-year period.

Keren E. Rodriguez, PharmD, CSP - Conceptualization; Data curation; Investigation; Methodology; Writing - original draft; Writing - review & editing.

Rachel Chelewski, PharmD, CSP - Conceptualization; Data curation; Investigation; Methodology; Writing - original draft; Writing - review & editing.

Megan E. Peter, PhD - Conceptualization; Methodology; Project administration; Writing - original draft; Writing - review & editing.

Autumn D. Zuckerman, PharmD, BCPS, AAHIVP, CSP - Conceptualization; Methodology; Project administration; Writing - original draft; Writing - review & editing.

Leena Choi, PhD - Data curation; Formal analysis; Visualization; Writing - original draft; Writing - review & editing.

Josh DeClercq, MS - Data curation; Formal analysis; Visualization; Writing - original draft; Writing - review & editing.

Anthony Langone, MD FAST - Conceptualization; Writing - original draft; Writing - review & editing.

Support: All authors are employed by Vanderbilt University Medical Center. The authors declare no relevant conflicts of interest or financial relationships. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Acknowledgments: We would like to acknowledge Jacob Bell, and Aaron Pavlik for their support in data extraction and analysis. We would also like to thank staff in the Renal Transplant Clinic and Transplant Pharmacy, without whom our initiatives in improving patient care would not have been possible.

Previous Presentations: R. Chelewski, K. Johnson, A. Zuckerman, J. Declerq, L. Choi, M. Peter, A. Langone. Development of a Collaborative Practice Pharmacy Agreement to Improve Efficiency and Management of Prescribing in a Renal Transplant Clinic.

❖ Gold ribbon poster presented at: Academy of Managed Care Pharmacy (AMCP) Annual Conference 2019 April 25-28; San Diego, CA.

❖ Oral Research Presentation (presented by R. Chelewski) at: American Transplant Congress (ATC) Annual Conference 2019 June 1-5; Boston, MA

❖ First place in outcomes poster presented at: National Association of Specialty Pharmacy (NASP) Annual Meeting and Educational Conference 2019 September 11; Washington DC

Key Points

What was already known:

❖ Pharmacist-led services in primary care have improved patient outcomes, such as better glycemic control, lower blood pressure and cholesterol, and fewer hospitalizations for patients with diabetes, hypertension, hyperlipidemia, and asthma.

❖ Pharmacists embedded in outpatient clinics perform services that are valuable to patients and physicians, including counseling patients, monitoring medications, reconciling medication lists, reviewing medication dose adjustments, coordinating refills, identifying and addressing medication nonadherence, and assisting with insurance authorizations.

❖ Collaborative pharmacy practice agreements (CPPAs) grant authorities to pharmacists without requiring direct physician supervision, maximizing the benefits pharmacists provide to patients and clinicians.

What this study adds:

❖ In this study, we described how we developed and implemented a CPPA at an outpatient renal transplant clinic with an integrated pharmacy.

❖ Integrating pharmacists with a CPPA into the clinic shifted workflow to allow pharmacists more responsibilities for managing prescription order generation.

❖ Our findings demonstrate how CPPAs can ease physician and nurse burden, offer an added resource in clinic, and support growth of the integrated pharmacy.