Specialty Pharmacist Integration in Neurology Clinics: A Model for Enhanced Patient Care

At the American Society of Health-System Pharmacists (ASHP) Pharmacy Futures 2025 meeting, presenter Madison Wood, PharmD, CPh, BCPS, reviewed a groundbreaking model for integrating specialty pharmacists directly into neurology care teams. Designed to manage patients with complex, chronic neurological conditions such as multiple sclerosis (MS), epilepsy, migraine, and movement disorders, the model aims to enhance medication access, streamline communication, and improve clinical outcomes.¹

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Baptist Health South Florida is a nonprofit health system comprising 12 hospitals, 4500 physicians, and 200 outpatient facilities. Within this expansive network, the neurology clinical pharmacy specialist serves a vital dual role. The position ensures continuous care coordination and medication oversight across the system’s specialty pharmacy and neurology practices.¹

“I am a go-between [for] our health system specialty pharmacy as well as our health system neurology clinics,” Wood explained.¹

Specialty medications, which are often high-cost and used to treat rare or complex conditions, require more support than what typical retail pharmacies can provide. In this model, pharmacists provide that support through a comprehensive patient management program. The program begins with a pharmacist-led initial assessment prior to dispensing, followed by a clinical check-in within 3 weeks. Unless issues arise, patients continue with follow-up visits every 6 months. In addition, pharmacy technicians conduct monthly refill adherence calls, and patients have the option for in-clinic assessments if needed.¹

The integrated model offers a marked improvement over the standard approach, which relies primarily on telephone communication and policy-driven timelines.

“Looking further at the benefits for the standard versus clinic integration for this patient program,” Wood noted, “for standard, the communication is primarily over the phone, and assessments and education are conducted based on the policy timeline. For integration, we are able to have a higher capture rate for patients… This also leads to a decrease in loss of follow-up, bridging gaps in communication.”¹

These services are supported by a collaborative practice agreement, which empowers the pharmacist to independently manage medications, order and monitor laboratory tests, oversee symptom management, and handle refills. This framework enables shared decision-making and offers clinical autonomy while easing physician workload. As Wood noted, this model “can help with formulary management, decrease physician burden in these processes, increase adherence, decrease gaps in therapy, and increase follow-up.” Pharmacists are also authorized to make dosing adjustments tailored to specific patient parameters.¹

Currently, the model is deployed across 5 practice sites, including 1 neurology clinic with an MS Center designation and 4 general neurology clinics. The care team includes 10 physicians, 6 advanced nurse practitioners, 3 registered nurses, and 2 infusion nurses. Providers consult pharmacists when a medication-related issue is identified during a patient visit. In many cases, the pharmacist resolves the issue independently, escalating to the provider only when necessary.¹

Another critical role of the clinical pharmacist is serving as a medication liaison, bridging gaps in communication and facilitating access to safe, cost-effective medications. This involves close coordination with specialty pharmacies, infusion services, retail pharmacies, pharmaceutical manufacturers, medication access programs, and industry representatives. The pharmacist’s reach in MS extends further—collaborating with neurologists, nurse practitioners, physical therapists, mental health providers, urologists, neuro-ophthalmologists, and long-term care professionals.¹

Evidence from recent studies supports the effectiveness of this approach. For example, integrated specialty pharmacy services have been associated with significantly reduced relapse rates in patients with MS.²

Baptist Health South Florida’s specialty pharmacist integration model represents a scalable and evidence-based solution to many of the challenges facing neurology care. By embedding pharmacists into care teams and empowering them with collaborative authority, the model not only improves medication outcomes but also strengthens interdisciplinary collaboration and patient satisfaction. As specialty medications become increasingly complex and prevalent, this approach may serve as a blueprint for other health systems seeking to enhance the quality and efficiency of neurological care.

REFERENCES

1. Wood M. Revolutionizing Ambulatory Care: Exploring Innovative Practice Areas. Presented at: American Society of Health-System Pharmacists 2025 Pharmacy Futures. Charlotte, NC; June 8, 2025. Accessed June 8, 2025.

2. Tang J, Chang C, Hong SH, et al. Effects of specialty pharmacy care on health outcomes in multiple sclerosis. Pract Managem. 2016;9(8).