PSHP 2026 Residency Conference

Purpose: Rheumatoid arthritis (RA) has persistent barriers to care, and pharmacists may help bridge these gaps. The purpose of this project was to evaluate the impact of clinical pharmacist integration in an outpatient rheumatology clinic.
Methods: A retrospective quality improvement project which reviewed interventions conducted by a clinical pharmacist embedded within Penn Rheumatology Washington Square. Patients included adults with RA with a documented intervention by the pharmacist, and those who were seen only for non-RA conditions were excluded. The primary outcome was change in RA disease activity as measured by the Routine Assessment of Patient Index Data 3 (RAPID3) at 1 and 3 months post-intervention. Secondary outcomes included the type, frequency, and time associated with pharmacist interventions, as well as changes in Clinical Disease Activity Index (CDAI) scores. This project was reviewed and determined to qualify and approved as quality improvement by the University of Pennsylvania’s Institutional Review Board.
Results: Of 25 patients with a documented clinical pharmacist intervention, all were included for analysis. Among patients with available RAPID3 data, the mean difference in RAPID3 scores from baseline to 1 month following pharmacist intervention was -2.27 (p = 0.068, n = 6) and from baseline to 3 months was 0.57 (p = 0.838, n = 12). The clinical pharmacist completed 182 interventions during the project period. The most common interventions included patient education, drug interaction checks, clinical and laboratory monitoring, comprehensive medication reviews, and medication list reviews. Time associated with interventions varied by subtype. No CDAI scores were documented at baseline or follow-up.
Conclusion: Although no statistically significant changes in RA disease severity were observed, integrating a clinical pharmacist into a rheumatology clinic yielded numerous meaningful, medication-focused interventions addressing known barriers to RA care. Findings highlight clinical and operational value of pharmacists in multidisciplinary rheumatology care, and an opportunity to standardize disease activity monitoring and enhance future outcome assessment.