Pharmacists as health care providers

Pharmacists are often seen as individuals who just dispense drugs.  However, pharmacists are increasingly considered as providers that are part of the broader health care team. My own research has shown that pharmacists are a more cost-effective and safe approach to getting vaccinations compared to primary care providers (see Fontanesi et al. 2009).  A Health Affairs Entry Point article describes how pharmacists are gaining new prominence in the move to improve patient safety.

In discussing the role of one pharmacist that is participating in this new paradigm, the article states:

In her new role, she is part of a team that includes a physician who does physician assessments and counselors for mental health needs. Being part of this team enables Miller to help patients overcome addiction, while still allowing her to remain in a retail pharmacy setting, where she interacts with patients coming in for refills and new prescriptions.

Pharmacists are helping to provide advice and surveillance in an effort to combat the opioid epidemic:

Her work includes speaking to patients about the potential risks of opioids; speaking up or making a note in patients’ records, if possible, about potential issues surrounding high doses; documenting details in her state’s prescription drug monitoring program; and knowing when and how to suggest that a patient obtain naloxone…In her position, she serves as the bridge between a patient seeking treatment and receiving it…

Pharmacists also can help to address medication non-adherence as well, a $300 billion problem in the U.S.  Major pharmacy chains are getting into the health care game as well:

…CVS and Walgreens are offering a number of programs to reduce readmissions, from bedside delivery of prescription drugs at hospital discharge to promoting safe and appropriate use once a patient leaves the hospital, home-based or telephonic pharmacist visits for medication reconciliation after discharge, and helping vulnerable patients navigate changes in therapy.

There are challenges to implementing this new paradigm.  First is reimbursement, as Medicare does not consider pharmacists health care providers. Second is incomplete information.  Pharmacists typically do not have full access to a patient’s EMR.

Despite these challenges, better integrating pharmacists into the care team offers a cost-effective way to improve quality of care.

• Gale, Rebecca. “In Patient Safety Efforts, Pharmacists Gain New Prominence”. Health Affairs. November 2018 37:11. DOI: 10.1377/hlthaff.2018.1225

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