Pharmacist home visits: A 1-year experience from a community pharmacy

Objective: To provide experience on the methods and costs for delivering a large-scale community pharmacist home visit service. Setting: Independent urban community pharmacy, Buffalo, NY. Practice description: Mobile Pharmacy Solutions provides traditional community pharmacy walk-in service and a suite of clinically oriented services, includingoutboundadherence calls linked to home delivery, payment planning,medication refill synchronization, adherence packaging, and pharmacist home visits. Pharmacist daily staffing included three dispensing pharmacists, one residency-trained pharmacist, and two postgraduate year 1 community pharmacy residents. Practice innovation: A large-scale community pharmacy home visit service delivered over a 1-year period. Evaluation: Pharmacist time and cost to administer the home visit service as well as home visit request sources and description of patient demographics. Results: A total of 172 visits were conducted (137 initial, 35 follow-up). Patients who received a home visit averaged 9.8 ± 5.2 medications and 3.0 ± 1.6 chronic disease states. On average, a home visit required 2.0 ± 0.8 hours, which included travel time. The percentages of visits completed by pharmacists and residents were 60% and 40%, respectively. The amounts of time to complete a visit were similar. Average home visit cost including pharmacist time and travel was $119 ($147 for a pharmacist, $77 for a resident). Conclusion: In this community pharmacyebased home visit service, costs are an important factor, with each pharmacist visit requiring 2 hours to complete. This experience provides a blueprint and real-world perspective for community pharmacies endeavoring to implement a home visit service and sets a foundation for future prospective trials to evaluate the impact of the service on important indicators of health and cost.