Abstract Background Patients with pulmonary arterial hypertension (PAH) are often prescribed multiple therapies with significant adverse effect profiles, creating barriers to medication adherence and treatment optimization. Rural patients are particularly vulnerable to medication errors and nonadherence due to limited access to care. To address these challenges, a pharmacist collaborative practice agreement (PCPA) was implemented within the outpatient pulmonary hypertension (PH) clinic at the Medical University of South Carolina. This pharmacist-driven model provides longitudinal management of medication-related adverse events—including fluid and electrolyte disturbances—while supporting medication access, education, monitoring, and adherence. Methods This interim single-center, retrospective descriptive study evaluated interventions made by integrated specialty pharmacists (SPs) for patients with PAH. Data were collected from the electronic health record (EHR). SPs provided medication education prior to and during therapy, assessed adverse reactions, and implemented management strategies for fluid, electrolyte, and medication-related side effects. Each intervention, including assessment type, management approach, monitoring parameters, and outcomes, was documented in the EHR. Resolution was defined as normalization of follow-up laboratory values or symptom improvement. Descriptive statistics were used for analysis. Results Among 62 patients who received pharmacist interventions, 119 interventions were documented: 41 (34.5%) for electrolyte abnormalities, 52 (43.7%) for fluid retention, 25 (21.0%) for medication side effects, and one (0.8%) for blood pressure management. 40% of patients required two to four interventions. Most patients lived within 50-100 miles of the clinic (62.9%); 30.6% lived within 50 miles, and 6.5% ≥150 miles away. Over half (53%) were on dual vasodilator therapy, and 74.2% had baseline WHO functional class III symptoms. Successful resolution occurred in 82.2% of patients (51/62). Five patients were lost to follow-up due to communication or laboratory coordination challenges. Pharmacists spent an average of less than 10 minutes per intervention, with most conducted independently under the PCPA and minimal direct physician involvement. Conclusions PAH patients frequently experience difficulty accessing therapies and managing adverse reactions, which lead to increased hospitalizations and frequent EHR inquiries. Integrated specialty pharmacy services play a key role in optimizing medication management for PAH patients while decreasing the burden of patient education on treating clinicians. These findings suggest that pharmacist-driven interventions may help prevent emergency department visits or hospitalizations related to PAH therapy complications. Through proactive monitoring, timely intervention, and collaborative care, pharmacists improve adherence, tolerance, and access while reducing clinician workload. By managing routine medication-related issues, integrated specialty pharmacy services enable physicians to focus on more acute or urgent patient needs. This abstract is funded by: None
Li et al. (Fri,) studied this question.