While pharmacists have always been a crucial component to healthcare and health outcomes for patients, it has only been in the last few years that their expanding role has been more embraced in the healthcare continuum. This has revealed many of the traditional and new ways that pharmacists can enhance patient care.
Today, pharmacists are becoming intimately involved in medication management, which addresses the entire spectrum of medications a patient may be taking. The goal is first to ensure a more holistic approach to drug-drug interactions. This means that when a patient is taking two or more drugs, that the pharmacist will take a collaborative role with the other healthcare professionals working with the patient to ensure that the drugs do not have unforeseen side effects due to their interactions.
This holistic approach goes even farther when the pharmacist and the entire medical team work together to ensure that all of the medications a patient may be taking are part of a complete list. This list (which today can become a part of electronic medical records and electronic health records) can then be shared among healthcare providers that are treating the patient.
This ensures that all medical team prescribers can work more collaboratively in an ongoing assessment of whether each medication is the best choice for the patient in terms of desired health outcomes for a targeted condition. In addition, the entire regimen of medications being taken by a patient can be more easily monitored to assess their collective effect on the general health and well-being of the patient.
For inpatient and patients transitioning from a hospital environment, this may mean transitional care and medication assessment in collaboration with physicians and specialists as part of a healthcare team. In other scenarios as with pharmacies it can mean patient education and adherence support and follow-up. This can include behavioral counseling to ensure patients take their prescribed medications in the correct ways. All of these efforts are focused on improving patients’ health outcomes.
Where the pharmacist was once outside of the care continuum as they were often separated from physicians, nurses, and specialists, the new healthcare landscape has led to an increasingly collaborative approach. This team-based approach, as in the Patient Centered Medical Home (PCMH) model of care, enables pharmacists to play a greater role in the health outcomes of patients by taking into account their experiences and knowledge. With patients who live with multiple chronic conditions, this approach takes advantage of the full potential of the pharmacist through medication therapy management (MTM).
Evidence of the effects of this enhanced role for pharmacists in healthcare has been the subject of a number of studies, reports, and papers. And now, legislative and advisory groups are pushing for expansion of this practice.
According to a recent AHRQ report titled “Medication Therapy Management Interventions in Outpatient Settings,” there is evidence that MTM programs can reduce the risk of adverse drug events and lower healthcare costs. This is based on pharmacists having access to brief clinical summaries from patient medical records.
A recent article in Managed Healthcare Executive profiled a model of this collaborative approach at a Wisconsin hospital and a study of its one-year outcomes. Findings showed a marked difference in patient outcomes such as a reduction in ED visits, hospitalizations, and projected cost avoidance to patients of some $604,000.00.
Although there are numerous cases of this level of collaborative team care across the country, there is currently a push to see this model become a nationwide standard practice. A recent paper presented by the National Governors Association (NGA) makes a strong case for this approach.
Entitled “Expanding Role of Pharmacists in a Transformed Health Care System,” the paper explores ways states can better integrate pharmacists into the healthcare delivery system. The paper makes the case for doing so through amendment of laws and regulations so that pharmacists are able to put into practice the full scope of what their profession can provide.
The new healthcare landscape of Accountable Care Organizations (ACO) and PCMH models of care will continue to expand the role of pharmacists in patient health outcomes. This is already having a profound impact on patient populations, hospitals, and communities across the country.
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