A peer-review study of the quality of care provided by pharmaceutical care practitioners in an ambulatory care clinic setting

Objectives. The overall objectives were to: (1) determine the level of agreement among the peer reviewers with the clinical decisions made by the pharmaceutical care practitioners, (2) determine what factors might decrease the level of agreement, and (3) determine the level of quality of the patient care provided by the pharmaceutical care practitioners.; Methods. The quality of clinical decisions made by pharmacists within this collaborative practice of pharmaceutical care was studied using a nine member panel of physicians and pharmaceutical care pharmacists, and nine randomly selected pharmaceutical care patients. This was a quality assessment and care process validation component of a study evaluating the effects of collaborative pharmaceutical care in a population of Blue Cross/Blue Shield Blue Plus patients. A structured implicit review process was used to assess the clinical credibility of clinical decisions made by pharmaceutical care practitioners.; Results. The most common medical condition was “other nutritional needs” (26%), followed by hypertension (11%), and diabetes and osteoporosis accounting for six percent each. Out of the 5796 ratings, the reviewers expressed agreement with the pharmaceutical care practitioner's decision in 91.24% of the ratings, and expressed disagreement with the decision in only 2.16% of the ratings. In addition, 6 or more reviewers agreed with a specific clinical decision in 99.84% of the cases.; Conclusion. The results from this study show that there was a very high level of agreement with the clinical decisions made by the pharmaceutical care practitioners. Although the pharmaceutical care pharmacist reviewers were more likely to give a higher agree rating than the physician reviewers, the physicians still had a very high mean rating. These high ratings and the almost 100% level of clinically credible agreement (99.84%), gives evidence to the fact that the Fairview pharmaceutical care practitioners are providing a high level of quality patient care.