TY - JOUR
AU - J. C. Carroll
AU - K. Doong
AU - S. Mitra
AU - M. S. McGivney
AU - S. H. McGrath
AU - K. C. Coley
A1 - 
AB - BACKGROUND: Community pharmacists frequently care for patients with complex medical and social needs; however, specific evidence on pharmacist perceptions of what makes a patient encounter complex has not been clearly characterized. There is a need to better understand specific factors that contribute to patient encounter complexity and demonstrate how pharmacists in community settings care for these individuals. OBJECTIVES: The objectives of this programmatic case study were to: (1) elucidate factors that contributed to patient encounter complexity as a part of a Medicaid Managed Care Organization comprehensive medication management payer program in community pharmacies and (2) curate a series of patient case vignettes that provide evidence of pharmacists care for patients with complex medical and social needs within community pharmacies. METHODS: This qualitative programmatic case study utilized data from semi-structured interviews with community pharmacists who provided comprehensive medication management services to Medicaid patients in Pennsylvania. Pharmacists described their most complex patient encounter. Interviews were transcribed and independently coded by 2 investigators. The coded texts were grouped into categories, and a cross-case inductive thematic analysis was performed to identify complexity factors. RESULTS: Thirty pharmacists provided 48 patient case vignettes and 3 complexity factors emerged: (1) care coordination; (2) behavioral health support; and (3) social determinants of health. Representative patient case vignettes were selected to illustrate these factors. CONCLUSION: Pharmacists, who participated in a community pharmacy Medicaid Managed Care Organization payer program, provided care to patients with complex health needs. In addition to medication-related problems, specific factors that increased pharmacist perception of encounter complexity were care coordination with other health care providers, behavioral health support, and addressing social determinants of health.
AN - 39396753
BT - J Am Pharm Assoc (2003)
C5 - Healthcare Policy; Healthcare Disparities; Education & Workforce
CP - 1
DA - Jan-Feb
DO - 10.1016/j.japh.2024.102264
DP - NLM
ET - 20241011
IS - 1
JF - J Am Pharm Assoc (2003)
LA - eng
N2 - BACKGROUND: Community pharmacists frequently care for patients with complex medical and social needs; however, specific evidence on pharmacist perceptions of what makes a patient encounter complex has not been clearly characterized. There is a need to better understand specific factors that contribute to patient encounter complexity and demonstrate how pharmacists in community settings care for these individuals. OBJECTIVES: The objectives of this programmatic case study were to: (1) elucidate factors that contributed to patient encounter complexity as a part of a Medicaid Managed Care Organization comprehensive medication management payer program in community pharmacies and (2) curate a series of patient case vignettes that provide evidence of pharmacists care for patients with complex medical and social needs within community pharmacies. METHODS: This qualitative programmatic case study utilized data from semi-structured interviews with community pharmacists who provided comprehensive medication management services to Medicaid patients in Pennsylvania. Pharmacists described their most complex patient encounter. Interviews were transcribed and independently coded by 2 investigators. The coded texts were grouped into categories, and a cross-case inductive thematic analysis was performed to identify complexity factors. RESULTS: Thirty pharmacists provided 48 patient case vignettes and 3 complexity factors emerged: (1) care coordination; (2) behavioral health support; and (3) social determinants of health. Representative patient case vignettes were selected to illustrate these factors. CONCLUSION: Pharmacists, who participated in a community pharmacy Medicaid Managed Care Organization payer program, provided care to patients with complex health needs. In addition to medication-related problems, specific factors that increased pharmacist perception of encounter complexity were care coordination with other health care providers, behavioral health support, and addressing social determinants of health.
PY - 2025
SN - 1086-5802
SP - 102264
ST - Complexity of patient encounters within a clinically integrated community pharmacy network Medicaid payer program
T1 - Complexity of patient encounters within a clinically integrated community pharmacy network Medicaid payer program
T2 - J Am Pharm Assoc (2003)
TI - Complexity of patient encounters within a clinically integrated community pharmacy network Medicaid payer program
U1 - Healthcare Policy; Healthcare Disparities; Education & Workforce
U3 - 10.1016/j.japh.2024.102264
VL - 65
VO - 1086-5802
Y1 - 2025
ER -