This study described the care coordination process and patient outcomes from decision to treat with ustekinumab through initiating subcutaneous (SQ) injection. Prescriptions filled with Vanderbilt Specialty Pharmacy (VSP) had 2.5 times higher odds of being shipped in the appropriate window compared to non-VSP with 56% dose-escalated during the first year. This study shows ustekinumab initiation and escalation in the first year can be a lengthy process requiring a high level of care coordination.

This study quantified VSP pharmacists’ work performed to facilitate specialty medication education, access, adherence, and persistence for patients who do not use VSP. Across 3 clinics over 5 months, pharmacists performed 1,645 actions for 714 non-VSP patients, equating to 375 hours and $30,429.48 in estimated pharmacist compensation. Lack of visibility in the patient journey and increased workload on providers and health systems is created when payers and manufacturers lockout IHSSPs.

This quality improvement project aims to evaluate implementation of a standardized process for specialty pharmacists to document and monitor patient disease severity and response to therapy using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), a patient reported outcome, administered via the electronic health record patient portal.

This study evaluated treatment outcomes (adherence, persistence, switching and discontinuation of therapy) and pharmacists' management of adverse events (AE's) in patients on an oral oncolytic for CLL/SLL. In a population of patients initiating oral CLL/SLL therapy through an integrated Health-System Pharmacy, adherence to therapy was high (mean PDC 92%). Adverse effects led to 36% of therapy discontinuations and 72% of therapy switches, indicating an opportunity for pharmacists to manage AE's.

This study evaluated how allergic comorbidities affect dupilumab persistence when prescribed for asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP). Non-persistence was 19% and 22% at 3 and 6 months, respectively. The median time to non-persistence was 66 days (IQR 25-95). Patients with commercial insurance and those with AERD were more likely to persistent.

This study evaluated the treatment of HCV using DAAs in pediatric patients using an integrated specialty pharmacy model. The model was effective in navigating patients through the treatment cascade of care to SVR. Additional pharmacist contacts were needed for 45% of patients unable to swallow the dosage form at the initial clinic evaluation. Linkage to care following initial clinc evaluation remains a challenge especially in those age 0-5 years.

This study evaluated prescription cannabidiol (CBD) outcomes including patient characteristics, adherence and discontinuation, and clinical outcomes during the first 12 months of therapy. Patients initiating therapy had complex medication use patterns. Adherence was high (PDC 94%), but 23% of patients discontinued in the first 12 months. Many patients (37%) utilized emergency healthcare services after CBD initiation. There was no significant change in concomitant ASM use.

This qualitative study used focus groups of pharmacy leadership and clinical pharmacists and semi-structured interviews with physician champions to evaluate the development and implementation of CPPAs in an IHSSP. Results demonstrated that implementation of a CPPA in a specialty clinic was thought to improve the quality and efficiency of patient care and was favorably accepted by clinic staff. The IHSSP structure allows CPPAs to be easily integrated in workflow.

This multi-phased survey aggregated data to describe clinical services provided by health-system specialty pharmacies (HSSPs). Results demonstrate that HSSPs are a clinical and educational resource for specialty clinics and have developed robust patient care services that encompass the patient journey from before specialty medication selection through treatment monitoring and optimization.

This study highlights how specialty pharmacists with access to patient medical records were able to postpone requesting oral anticancer medication refills for patients with upcoming follow-up and sufficient medication on hand. Therapy was discontinued or changed in 98% of postponed requests accounting for over $750,000 in costs avoided based on AWP-20% pricing.