Specialty pharmacists integrated into non-multiple sclerosis (MS) neurology clinics can significantly improve patient care through high-impact interventions, according to new research presented at the American Academy of Neurology 2025 Annual Meeting in San Diego.
The study, led by Kayla Johnson, PharmD, BCPS, BCPP, clinical pharmacist specialist at Vanderbilt University Medical Center, demonstrated that pharmacists performed over 2,000 interventions across 741 patients during a three-month period, with providers accepting 98% of nearly 400 clinical recommendations.
"If you ask a patient to wait 3 months for some safety testing or for modification to their therapy, then that might put them at risk of poor outcomes and may lead to medication non-adherence or loss of medication fulfillment," Johnson explained in an interview with Pharmacy Times.
Study Design and Patient Population
The single-center, retrospective cohort study examined pharmacist interventions across multiple non-MS neurology specialties, including adult and pediatric epilepsy, movement disorders, neuromuscular disorders, autonomic disorders, and transthyretin amyloidosis at an academic medical center with an integrated health system specialty pharmacy.
The study population had a median age of 60 years, with an approximately equal gender distribution and predominantly White demographic. Most patients utilized the center's specialty pharmacy for medication fulfillment.
Types of Interventions and Impact
For patients using the health system's specialty pharmacy, the most common interventions included:
- Therapy changes (35%)
- Patient counseling (10%)
- Assistance with appointment scheduling or referrals to urgent care/emergency departments (10%)
- Safety monitoring
For patients using external pharmacies, the most frequent interventions involved financial assistance referrals and transferring prescriptions between pharmacies based on patient preference or payer requirements.
Measuring Intervention Impact
Researchers employed a standardized 4-point impact scale to evaluate the significance of pharmacist interventions:
- Level 1: Chart review only, no intervention performed
- Level 2: Interventions affecting quality of life
- Level 3: Interventions preventing non-life-threatening negative health impacts
- Level 4: Interventions preventing potentially fatal outcomes
Notably, 76% of interventions were classified as Level 2, indicating a substantial positive impact on patients' quality of life, which Johnson noted "may lead to better treatment satisfaction, better adherence, and persistence with medication therapies."
Implications for Neurology Care Models
The findings highlight the value of integrating specialty pharmacists into neurology care teams, particularly for complex conditions requiring specialized medications and monitoring. By providing timely interventions between physician visits (typically scheduled at 3-month intervals), pharmacists help prevent treatment delays that could otherwise lead to poorer outcomes.
"This really helps to show the benefit of the pharmacist," Johnson emphasized, noting that the high acceptance rate of pharmacist recommendations (98%) demonstrates the clinical team's recognition of pharmacists' expertise.
The study suggests that expanding the role of specialty pharmacists in neurology clinics could be a cost-effective strategy to improve medication management, enhance patient education, and optimize treatment outcomes across various neurological conditions.
