{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:25:49Z","timestamp":1773786349229,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,3]],"date-time":"2016-10-03T00:00:00Z","timestamp":1475452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL125984"],"award-info":[{"award-number":["K23HL125984"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:p>Ambulatory care clinical pharmacy services have expanded beyond primary care settings, but literature supporting the benefits of clinical pharmacy involvement with patients who have rare diseases such as sickle cell disease (<jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>) is lacking. Hydroxyurea is the only agent approved by the U.S. Food and Drug Administration for the treatment of <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>; full benefit in controlling pain episodes and other complications is achieved through monitored escalation to a maximum tolerated dose. The primary objective of this analysis was to evaluate the impact of a newly implemented clinical pharmacy service on the management of patients with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>. We performed a retrospective cross\u2010sectional analysis of 385 adults with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> who received care between January 1, 2014, and December 31, 2014, at a single Sickle Cell Outpatient Center that implemented a clinical pharmacy service in August 2013. Data were collected on hydroxyurea dose escalation, immunization completion rates, and health maintenance metrics (screening for nephropathy with microalbuminuria testing, retinopathy with annual retinal examinations, and pulmonary hypertension with echocardiography). The impact of the clinical pharmacy service on quality measurements was evaluated by using univariate and multivariate analyses. The number of pharmacist encounters, defined as a clinic visit when a clinical pharmacist interacted with a patient as documented in the medical records, was associated with an improved hydroxyurea dose escalation rate (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 1.48, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.07\u20132.05, p=0.02). Immunization rates for the 23\u2010valent pneumococcal polysaccharide vaccine, the 13\u2010valent pneumococcal conjugate vaccine, and influenza vaccine were 66%, 47%, and 62%, respectively. The number of pharmacist encounters was associated with improved immunization completion rates (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.38, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.17\u20131.62, p&lt;0.001). Improved screening for microalbuminuria (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.14, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.60\u20132.86, p&lt;0.001) and sickle cell retinopathy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.16, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00\u20131.35, p=0.05) were also associated with the number of pharmacist encounters. A new clinical pharmacy service implemented in managing a rare disease, <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>, was associated with an improved hydroxyurea dose escalation rate, immunization completion rates, and health maintenance metrics.<\/jats:p>","DOI":"10.1002\/phar.1834","type":"journal-article","created":{"date-parts":[[2016,9,16]],"date-time":"2016-09-16T10:33:06Z","timestamp":1474021986000},"page":"1166-1172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of a Clinical Pharmacy Service on the Management of Patients in a Sickle Cell Disease Outpatient Center"],"prefix":"10.1002","volume":"36","author":[{"given":"Jin","family":"Han","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice College of Pharmacy University of Illinois at Chicago Chicago Illinois"},{"name":"Comprehensive Sickle Cell Center Section of Hematology\/Oncology Department of Medicine University of Illinois at Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubha","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice College of Pharmacy University of Illinois at Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Gowhari","sequence":"additional","affiliation":[{"name":"Comprehensive Sickle Cell Center Section of Hematology\/Oncology Department of Medicine University of Illinois at Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor R.","family":"Gordeuk","sequence":"additional","affiliation":[{"name":"Comprehensive Sickle Cell Center Section of Hematology\/Oncology Department of Medicine University of Illinois at Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santosh L.","family":"Saraf","sequence":"additional","affiliation":[{"name":"Comprehensive Sickle Cell Center Section of Hematology\/Oncology Department of Medicine University of Illinois at Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904013401307"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.022"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21408"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21807"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct0708272"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.13.1645"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10517"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6430a3"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2015.8"},{"key":"e_1_2_6_11_1","unstructured":"Evidence\u2010Based Management of Sickle Cell Disease: Expert Panel Report 2014.NHLBI\/NIH. 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