Enhancing evidence-based decision making through primary care provider–pharmacist collaboration and patient simulation training

<h2>Abstract</h2><h3>Background</h3> Traditionally, physicians' and pharmacists' roles have been distinct. However, an aging population, increasing prevalence of chronic conditions, the growth of value-based care payments, and forecasted shortfalls in primary care providers (PCPs) are forcing a rethinking of this paradigm. Creating opportunities for collaboration between PCPs and pharmacists presents an opportunity to address these challenges. This study explores the impact of this collaboration on evidence-based decision making at Village Medical and Walgreens. <h3>Methods</h3> Online simulated cases of patients with diabetes were randomly assigned to PCPs alone or PCP-pharmacist dyad pairs. The patient simulations were administered in 3 seasons in 2023, and participants completed the cases by making care decisions and receiving real-time feedback on improvement opportunities. Care decisions were scored against evidence-based guidelines. In the first season, PCPs completed cases alone to establish a practice baseline. For the next 2 seasons, 40 PCPs were each paired with a pharmacist and asked to complete their next 2 seasons of patient simulations together. Care decisions made by the dyad pairs were compared with 40 Village Medical matched PCPs completing the cases on their own. <h3>Results</h3> In the baseline season, we found no difference in the treatment domain between the predyad and control PCPs (64.0% vs. 63.2%, respectively). By the final season, treatment scores improved for both groups (up to 72.9% for the dyads and up to 68.9% for control), a difference-in-difference improvement of +3.2% for the dyads (<i>P</i> = 0.497). Stopping sulfonylureas and prescribing sodium-glucose cotransporter-2 inhibitors showed noteworthy difference-in-difference improvements among the dyads: +16.2% (<i>P</i> = 0.501) and +23.1% (<i>P</i> = 0.296), respectively. <h3>Conclusion</h3> This proof-of-concept study provides evidence that PCP-pharmacist collaboration can improve care decisions, especially in polypharmacy management, medication deprescribing, and evidence-based integration of new medications. The results support continued efforts to enhance collaboration between pharmacists and primary care to improve care quality.