The Impact of the Covid-19 Pandemic on the Scope of Ambulatory Care Pharmacy Practice

This investigation aims to highlight the impact of the COVID-19 pandemic on the scope of ambulatory care pharmacy at academic, community, and rural hospitals throughout California to elucidate the differences in pharmacists’ roles pre-COVID-19 compared to during the COVID-19 pandemic.

This study involved an online Qualtrics survey consisting of multiple choice and short answer questions, followed by a virtual semi-structured interview with predisclosed questions through Zoom. The Qualtrics survey was administered prior to the interview to collect background information on ambulatory practice in academic, research and rural hospital institutions. The data points collected were changes in patient care/interactions, number of telehealth visits, patient demographics, workflow and protocols and changes in administration and management. The virtual interviews were conducted with ambulatory care pharmacy managers and staff pharmacists recruited from academic, research, and rural hospitals in California. Interviews were recorded, transcribed and coded with inductive thematic analysis. The primary outcome was defined as key differences in pharmacy practice prior to and during the COVID-19 pandemic.

Increased telehealth was an overarching theme connecting administrative changes, provider impact and patient engagement. COVID-19 accelerated the use, organization of, and billing issues for pharmacists related to telehealth visits, highlighting the need to recognize pharmacists as providers. Some pharmacists found expansion in their breadth of practice, or were relied on more by other providers, leading to increased work volume. Staffing amongst pharmacy services was consistent; many felt increased burnout but valued as they practiced at the top of their license. Telehealth offered flexibility and convenience to pharmacists and patients and allowed more patients to attend appointments with their caretakers. Conversely, virtual visits were not ideal for physical examinations and building rapport and trust.

The COVID-19 pandemic increased telehealth in ambulatory care pharmacy practice, leading to significant changes in administration, provider impact and patient engagement.