As the most accessible health care professionals, pharmacists are the “guardians” of safe and effective medication use. States are considering expanding the scope of practice for pharmacists and even recognizing pharmacists as providers! These are necessary steps to take pharmacy practice to the next level and to more comprehensively realize the benefit of having a pharmacist manage a patient’s medication regimen. While state-based updates are significant, it’s still a localized process where there could be barriers to implementation such as setting up payment models which pharmacists can utilize or training to expand other services.
Pharmacists will always have a role in the process of medication dispensing. But, to fully recognize the role and benefit of the pharmacist we must move towards recognition of pharmacist services that can be separate and distinct from the dispensing of a medication.
Let’s review how pharmacists can contribute to improving patient health through other services. These may or may not occur within the confines of a community pharmacy location as we know it today. We are beginning to witness many companies disrupt the market with innovative ways to optimize the role of the pharmacist for the future.
- Evaluating medication appropriateness – This is perhaps the best role for a pharmacist that is appropriately utilized as a member of the health care team! The schools and colleges of pharmacy include rigorous training in medicinal chemistry and therapeutics. While physicians and other health care professionals may have extensive training on diagnosis and treatment plans, the pharmacists are the ultimate resource when it comes to managing and adjusting a medication action plan. This may include reducing dosing or frequency of a medication, identifying combination products that can reduce “pill burden” or removing medications that are unnecessary or redundant!
- Improving medication adherence – Pharmacists have a unique opportunity to meet with patients routinely in the community and often have more touchpoints with a patient than any other health care provider. Improving a patient’s adherence to a medication is meaningful, but it is not the only task. Any opportunity to improve adherence should always include an appropriate medication review first! In many instances, a patient may have prior issues with medication adherence because they experienced side effects, were not receiving a clinical benefit or had issues with cost for the therapy. Pharmacists counseling to improve adherence therefore should always consider these key elements. To state the goal more specifically, we want the patient to be taking the right medication every time to improve their health.
- Health and Wellness Services – when I was completing pharmacy school about 10 years ago, my training included much more than just learning about medications. Learning to provide other services along with other health care providers were part of the curriculum! Some of these services may include but are not limited to: screenings for blood pressure, blood glucose or cholesterol, immunization assessment and screening, and smoking cessation. In many cases, patients may not receive these services at their physician’s office or from a health system but from an ambulatory clinic. Pharmacists should consider how they can provide the service and how they can advertise it to local patients, employers and other health care providers.
- Transitions of Care: hospitals and health systems continue to face pressure to reduce hospital readmissions and improve care of patients once they return to the community. Too frequently, patients may be on a regimen of medications when they are admitted, and any medications they were on prior to the stay may be adjusted or held while in the facility. When the patient is discharged, changes to dosing, medications temporarily halted or temporarily added can add to the complexity of care and lead to confusion with the medication action plan. Pharmacists are once again positioned as the medication experts to review every medication for appropriateness.
We may be preaching to the choir, but pharmacists remain an underutilized resource in the health care continuum. Pharmacists have the education and training necessary to improve the medication process and our continued efforts to recognize pharmacists for their role(s) outside of dispensing are a welcome change to the current status-quo of pharmacy operations!