The American Journal of Health-System Pharmacy  Unveils Landmark CPS Study Examining Health System Specialty Pharmacy Impact on Patients Living with Multiple Sclerosis

CPS study is the first to use real-world data from specialty pharmacies to demonstrate how they improve interventions for patients living with multiple sclerosis.

March 2024

Health-system specialty pharmacy (HSSP) teams are integral in caring for patients living with multiple sclerosis (PwMS). They facilitate medication access, provide counseling, improve adherence, and decrease provider workload.

However, until recently, pharmacist interventions and their acceptance rates among PwMS have not been widely studied...until now.

The American Journal of Health-System Pharmacy (AJHP) recently published CPS's HSSP clinical outcomes study, "Health-system specialty pharmacist intervention types, acceptance, and associated actions for patients with multiple sclerosis."

It's the industry's first study using real-world evidence (RWE) to identify the types and acceptance rates of pharmacist-led clinical interventions for PwMS.

Below, the manuscript's authors reflect on the findings and takeaways for the HSSP community. Authors include: Alexis C. El-Khouri, PharmD; Carly Giavatto, PharmD; Amanda Hickman, PharmD, MPH, MSCS; Casey Fitzpatrick, PharmD, BCPS; Jessica Mourani, PharmD; Kipp Tiger, PharmD, CSP; Megan Rees, PharmD, BCACP, CSP; Ana I. Lopez-Medina, PharmD.

CPS: Congratulations! How are you feeling about the paper being published in AJHP?

AUTHORS: 

Anything that helps to advance care for PwMS makes us excited! We are grateful for the opportunity to show our findings and the value that HSSP teams deliver when integrated into neurology care teams.
We also appreciate the opportunity to disseminate our findings to a wider audience and hope the findings encourage others to adopt similar approaches.

CPS: Can you tell us about the study and its impact for PwMS?

AUTHORS: Absolutely! To our knowledge, it is the first study using real-world data to examine pharmacist interventions and outcomes in PwMS.

The purpose of our study was to identify the types and acceptance rate of clinical interventions completed by pharmacists for PwMS.

This research helps us measure where pharmacy can have an impact. Importantly, it also helps all of us understand where PwMS need more support to improve outcomes in the future.

CPS: Why did we conduct the research?

AUTHORS: HSSP pharmacists are integral for the care of PwMS. However, current literature detailing pharmacist interventions and their acceptance rates in this population is limited. Without detailed evidence that demonstrating how HSSP teams improve MS management, it can be challenging for health systems to justify integrating them into the neurology care team.

Additionally, if the role of a pharmacist is not fully understood by a healthcare team, their expertise may be under-utilized. This could create more work for other healthcare team members and potentially poorer outcomes for patients.

HSSP teams can make a significant impact, and demonstrating their value will advance care for PwMS.

CPS: What were the most interesting findings from the study?

We think it is interesting that when patients reported a side effect to a medication, only 50 percent of those were confirmed adverse drug reactions (ADRs). This result shows the importance of understanding the medications, the disease state, and the stress PwMS can have with figuring out what, specifically, is causing their symptoms in this completely individual, unpredictable disease state. 

It was also interesting to learn that close to a third of medication adherence issues stemmed from access issues. When non-adherence happens, it’s common for us to counsel patients to improve habits and practices. However, our findings show non-adherence is due to inability to access medications, which are situations commonly outside of the patient’s control. This is where we can focus on making improvements.

CPS: What do the results highlight about HSSP teams caring for PwMS?

AUTHORS: The results affirm specialty pharmacy teams have a positive impact on care for PwMS. There are three key learnings to take away:

• We found HSSPs play an important role developing therapy plans and ensuring patients receive personalized care.
• HSSPs reinforce neurology care teams, providing support as our provider peers face workforce shortages and other pressures.
• We learned online dashboards were valuable in collecting the RWE and outcomes data to document interventions and patient management.

CPS: What can other HSSP teams learn and apply from our study?

AUTHORS: There are several lessons to be learned from this research:

• When we know where HSSP teams make the most impact, the care team can ask the right questions and investigate barriers to care.
• The data also help us understand identify when and where PwMS may benefit from additional support from their pharmacy team.
  
• Increasing touch points and communications between pharmacists and patients allows for stronger connections and additional opportunities to identify concerns.

CPS: How will the findings advance HSSP clinical practice and outcomes for PwMS?

AUTHORS: We hope others will use this paper as a model for managing care for PwMS in neurology clinics.

Not only can we improve patient care, but we can also help each other find better balance. When HSSPs are part of the neurology care team, they can fill resource gaps created by workforce shortages. We hope our peers will consider how HSSP teams can solve this care gap by reducing the overall workload on providers and supporting staff.

CPS: How can we continue to advance research and care for PwMS?

Future studies are needed to evaluate if barriers like prior authorizations and financial assistance impact the timeline between provider visits and the start of therapy.

Additionally, it would be interesting to see the results from studies evaluating pharmacist involvement in identification of potential disease progression and appropriate DMT selection.

Finally, we hope that this project will inspire others to conduct similar studies and build upon our findings to further detail the roles and benefits of having a health system specialty pharmacist on neurology care teams.