By Gina Shaw
Specialty pharmacists embedded in a pulmonary arterial hypertension (PAH) clinic significantly improved management of side effects and boosted treatment adherence, according to new data presented at the NASP 2025 Annual Meeting & Expo, in Denver.

Researchers from the Medical University of South Carolina (MUSC) evaluated interventions for 62 patients treated between January 2024 and April 2025 (poster OPR32-OR). Pharmacists documented 119 interventions addressing electrolyte abnormalities (41), fluid retention (52), medication side effects (25) and hypertension (1). A successful resolution was achieved in 89.5% of patients (51/62), with 81.5% of individual interventions (97/119) effectively resolving the identified problems. Five patients were lost to follow-up due to communication or laboratory coordination challenges.

“PAH medications usually give our patients a lot of temporary side effects, especially during the first couple of weeks on therapy,” said presenting author Jiaying Li, PharmD, a clinical pharmacy specialist at MUSC, in Charleston. “What we found is that patients often wouldn’t tell anybody and would just stop taking their medication, because they didn’t realize the side effects were temporary.”

MUSC established a collaborative practice agreement authorizing specialty pharmacists to manage side effects, fluid balance and electrolyte abnormalities. Providers in the PAH clinic refer eligible patients, and pharmacists then deliver education, monitor lab parameters and intervene as needed, documenting out-comes in the electronic health record.

“When I came into this clinic, I saw a great opportunity for specialty pharmacists to intervene,” Dr. Li said. “With the collaborative practice agreement, when a provider identifies a patient, they can refer them to us, and we make the intervention, provide education and track it.”

Symptom resolution was defined as patient-reported improvement or normalization of laboratory parameters. Five patients were lost to follow-up due to communication or lab coordination challenges. Of the 51 patients who achieved resolution, 32 filled their PAH prescriptions through MUSC’s specialty pharmacy.

Dr. Li emphasized the clinical significance: “We see positive impacts on patient care, keeping patients on their medication and potentially preventing emergency room visits and hospitalizations,” she said.

The MUSC team is planning a second phase that ties interventions to disease-specific patient-reported outcomes, including the EmPHasis-10 questionnaire and functional class assessments. “We’ve built those measures into our electronic health record and will be tracking them,” Dr. Li said. “Hopefully the next phase will show that our interventions not only resolve side effects but also improve quality of life and reduce hospitalizations and emergency visits.”

Dr. Li reported no relevant financial disclosures.

https://www.pharmacypracticenews.com/Online-First/Article/09-25/Specialty-Pharmacists-PAH-Management-Improvement/78323