Expanding the Role of Independent Pharmacies: Initiating a Chronic Care Management Program

Independent community pharmacies are well positioned to expand clinical services through Chronic Care Management (CCM), yet implementation models remain limited. This prospective observational study evaluated the implementation of a pharmacist-led CCM program at an independent pharmacy in Northern Florida from October 2025 to March 2026. Eligible patients included individuals with two or more chronic conditions enrolled in CCM services. The primary outcomes included the volume and disposition of patient outreach attempts during implementation of the CCM program and the initial cost required to implement the CCM program within the independent community pharmacy. The secondary outcome was staff satisfaction with the implementation and operation of a CCM program in an independent community pharmacy, measured using an anonymous staff satisfaction survey administered approximately five months after program implementation. Program implementation included the development of infrastructure, staffing, patient recruitment, and monthly care management calls. During the beginning of the implementation of the program, the independent pharmacy had the possibility to reach around 16,000 patients. Out of those, we were able to make about 13 calls per day reaching only about 8% of the patients. A total of 3906 call attempts were made during the study period. Of these, 1172 calls (30.0%) were answered and completed, resulting in an overall completion rate of 30.0%. The majority of attempts (2041 calls; 52.3%) resulted in no answer, while 316 calls (8.1%) were declined by patients. The remaining 377 calls (9.6%) were categorized as other outcomes, which included voicemails, busy signals, disconnected lines, and incorrect contact numbers. A total of 3906 call attempts were made, with 1172 answered and engaged calls completed (30.0%). The most common unsuccessful outcome was no answer (52.3%), while follow-up calls demonstrated higher completion rates than cold-call outreach. Startup costs were approximately $14,080, excluding ongoing personnel expenses for three full-time and three part-time staff members. Staff satisfaction surveys (n = 13) demonstrated an overall mean composite score of 22.8 out of 30 with positive perceptions of role clarity, teamwork, and program effectiveness, though workflow inefficiencies and patient engagement barriers were identified. Despite operational challenges, implementation was possible and highlighted the potential for independent pharmacies to implement a pharmacist-led CCM service. Further evaluation of improved patient outcomes, sustainability, and workflow optimization strategies is warranted.