P2.194: Implementation of Pharmacy Services to a Pediatric Weight Management Clinic: changes in prescribing and prescription capture rate

Background: In July 2024, a pediatric weight management (WM) clinic introduced pharmacist services to optimize medication management and streamline administrative processes. Historically, clinic nurses managed prior authorizations, while providers handled medication appeals with insurance companies. From 2022 to early 2024, intermittent manufacturer shortages of glucagon-like peptide-1 receptor agonists (GLP-1) posed significant challenges to patient treatment plans, disrupting continuity of care and limiting therapeutic options.
The integration of pharmacy personnel aims to address these barriers by leveraging their expertise in medication management, insurance navigation, and patient education. This program evaluation explores the impact of pharmacist services on improving treatment outcomes, alleviating administrative burdens, and navigating medication shortages to better support patients in achieving weight management goals.

Methods: A shared pharmacist started working with the clinic in July 2024, supporting four other ambulatory care clinics weekly. The pharmacist streamlined prior authorization processes by utilizing preferred drug lists for individual patient insurances and assisting with appeals and documentation. In November 2024, a trained pharmacy technician joined the team, managing prior authorizations and contacting patients to monitor GLP-1 dose toleration and titration. The pharmacist remains accessible throughout the week to address provider inquiries and provide updates to the WM clinical team regarding drug availability, insurance formulary changes, and monthly medication updates.

Results: During FY 2024 (July 2023–June 2024), the weight management (WM) clinic prescribed a total of 1,383 prescriptions, averaging 115 per month. Over the fiscal year, 9% of these prescriptions were captured by Children’s Mercy outpatient pharmacies, with the capture rate ranging from 4.4% to 17.9%. In the first half of FY 2025 (July–December 2024), the clinic issued 1,414 prescription orders, reflecting an average of 235 per month, a substantial increase compared to FY 2024. Furthermore, the percentage of prescriptions captured by Children’s Mercy outpatient pharmacies steadily rose from 9.9% in July 2024 to 17.86% in December 2024, showcasing consistent growth in engagement with these pharmacy services.

Conclusion: The addition of a pharmacist to this WM clinical team, even without being staffed in clinic daily, has positively influenced prescription order volume and the percentage of prescriptions captured by Children’s Mercy outpatient pharmacies. Continued analysis throughout FY 2025 will help evaluate the sustained impact of pharmacy personnel, particularly as early 2025 insurance changes increase medication access for many patients. This collaborative approach may provide valuable insights expanding pharmacy services within outpatient ambulatory care clinics.