A Multi-Center Time Study of Home Infusion Pharmacist Professional Services for Specialty Infusion Medications

Introduction Specialty infusion and injection medications are key growth areas in home infusion services. According to the National Home Infusion Association (NHIA), over 315,000 specialty patients were served by home infusion pharmacies in 2019, with specialty infusions consistently representing approximately 10% of total patients. Despite the well-documented positive impact of specialty pharmacists on clinical and non-clinical patient outcomes, there is a lack of data on the specific tasks and time that pharmacists dedicate to furnishing specialty medications in home infusion settings. This study aims to fill this gap by quantifying the time spent and categorizing tasks performed by home infusion pharmacists caring for patients receiving specialty medications. Methods A descriptive, multi-center study was conducted by the National Home Infusion Foundation (NHIF). An expert committee determined the specialty therapy types included in the study, dispensing cycles, pharmacist task categories, and examples of tasks within each category. Pharmacists from participating home infusion providers self-reported time spent on clinical and administrative tasks using standardized tracking spreadsheets. The study tracked pharmacist time from the patient referral to the completion of 2 dispensing cycles, with tasks categorized based on clinical care activities, including drug preparation, patient assessments, and care planning. Results There were 563 pharmacist tasks provided to 72 home infusion patients across 6 states, with the mean number of pharmacist tasks per patient being 7.82 (SD = 3.404). Drug preparation and compounding activities were the most frequent tasks, followed by patient assessments and care planning. The study revealed that the mean pharmacist time spent per patient was 2 hours and 31 minutes (SD = 1:21). There were notable differences between therapy types. A key finding was that 71.58% of pharmacist tasks were dedicated to patient care, highlighting the intensive clinical involvement required for these medications. The study also showed little difference in the overall pharmacist time between infusion and injectable administration methods. However, care planning and patient assessments were more prominent for self-injectable drugs, indicating a higher degree of clinical management. Discussion The findings of this study underscore the critical role of pharmacists in furnishing specialty infusion services, with implications for staffing and reimbursement policy decisions. The data suggests a significant workload associated with clinical tasks and care coordination. Conclusion This study is the first to systematically quantify and categorize the professional work of home infusion pharmacists caring for specialty infusion medication patients. The results emphasize the substantial commitment of pharmacist time to clinical care, underscoring the complexity of specialty infusion medications and their management in home settings.