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Pharmacy and Pharmaceutical Sciences


Timothy Cao, PharmD, PGY-1 Pharmacy Resident

Preceptors: Adam Saulles, PharmD, CSP, BCACP and Tara Berkson, PharmD, BCACP

Providence Health and Services, Portland, Oregon

Implementation and evaluation of pulmonary arterial hypertension clinical program and pharmacist education at a health-system specialty pharmacy

Pulmonary Arterial Hypertension (PAH) is a progressive, debilitating, and costly disease, often resulting in poor prognosis when treatment is inadequate. With an exponential growth of specialty therapies, clinical pharmacists in specialty pharmacies are well-equipped to play an integral role in improving patient care outcomes and reducing overall healthcare costs. By incorporating a PAH-specific clinical program as part of the specialty pharmacy workflow, clinical pharmacists can provide meaningful interventions, such as evaluation of disease-modifying medications through individualized assessment of disease state symptoms, reconciliation of medications to assess for drug interactions, and laboratory parameter, compliance with Risk Evaluation & Mitigation Strategies (REMS) programs, while dispensing medications in a safe and cost-effective manner.

The purpose of this study was to develop and implement a PAH-specific clinical assessments and workflow, while providing enhanced pharmacist education, training & resources in a health-system specialty pharmacy setting.

This was a single-centered, quasi-experimental and implementation study with retrospective review at a health system specialty pharmacy. The primary objective of this study centered on building PAH-specific “new patient” and “patient follow-up” assessments and providing specialty pharmacists enhanced PAH and REMS education and training. The effectiveness of pharmacist education was evaluated based on pre-and- post clinical assessments during two targeted training sessions before the launch of the new workflow, along with a final clinical assessment one-month post-workflow launch. The secondary objective of this study focused on the quality of patient intervention during the implementation phase and pharmacist satisfaction with PAH/REMS-focused education. A retrospective report was run from the specialty pharmacy electronic health record (EHR) from February 2nd, 2020 to April 17th, 2020 for all completed PAH assessments and pharmacist interventions.

Primary objective results found upward trend in pharmacist competency and readiness following two PAH/REMS education sessions. Clinical assessments during pre-implementation phase found average pre-test results of 43.5% and post-test results of 74%, indicating 70% increase in pharmacist competency. High level of proficiency was sustained one-month post-implementation phase with mean competency at 85% and above. Pharmacist readiness in PAH management increased by 67% overall. Secondary objectives found majority of pharmacists were satisfied with the PAH education, implementation process and resources provided. EHR retrospective review identified several meaningful pharmacist interventions, notably drug utilization and interaction reviews, lab parameter assessments, side effect management and medication educations. High cost, complex medication regimens were dispensed according to REMS criteria and delivered to patients safely within an average of 3.5 days to ensure patient continuation of therapy.

PAH clinical program implementation and targeted- education successfully enhanced pharmacists’ clinical knowledge, readiness, and meaningful intervention for PAH population in a health-system specialty pharmacy.




Graduate Medical Education

Conference / Event Name

Academic Achievement Day, 2020


Providence St. Vincent, PGY-1 Pharmacy Residency Program

Implementation and evaluation of pulmonary arterial hypertension clinical program and pharmacist education at a health-system specialty pharmacy