Pharmacists are one of the most accessible health-care professionals.1 Traditionally, pharmacists have taken an active role in educating patients about their disease states, medications, and side effects, and have been involved in medication therapy management (MTM) services for some time.
With the shift from the fee-for-service model to the pay-for-performance model, there is an emphasis on service and quality, which drives needed quality measures. Payment models such as accountable care organizations and patient-centered medical homes will shape opportunities for pharmacists to contribute their services in novel ways.
In recent years, health coaching has become a new opportunity for pharmacists. A health coach is a person who uses evidence-based skillful conversation, clinical interventions, and strategies to actively and safely engage clients or patients in changing their health behaviors. Health coaches are trained to safely guide clients and patients who may have chronic conditions or who may be at moderate-to-high risk for chronic conditions.2
Not only are pharmacists equipped to help patients with medications, but they are positioned to use health coaching skills, such as motivational interviewing, to empower patients to an optimal state of health.
With changes in quality measures used by the Centers for Medicare and Medicaid Services, physicians are finding it more challenging to create time to discuss and empower patients to adapt healthy behaviors. Pharmacists can help bridge the gap between what the physician tells the patient to do and the actionable steps the patient can take to improve their health. As noted in a study on adherence,3 an overall 40% of patients did not adhere to their doctors’ prescription recommendations. Another 35% neglected to fully follow through on suggested physical therapy directives. Nonadherence to physician-recommended changes in lifestyle habits was 70%.
Every patient can benefit from health coaching. Lifestyle behaviors are the primary reason for many chronic health problems and are the primary cause of death and disability in the United States. Epidemiological data from more than 1.5 million claims indicates that heart disease, cancer, many types of chronic pain, high cholesterol, hypertension, intestinal problems, diabetes, sleeping problems, arthritis, obesity, anxiety, and depression are the leading reasons for medical and pharmacy costs and for absenteeism costs.4
For some patients, a feeling of disempowerment can substantially impair their ability to implement lifestyle changes and to adhere to medical directives. They need ongoing communication, patient education, and support to achieve the desired results of their drug therapy. Health coaching helps empower patients to take ownership of their health and well-being. Health coaches model key skills related to lifestyle change and personal growth, empowering their clients with a sense of individual mastery and personal accountability.
When it is time for follow-up visits with their health-care providers, patients will be better able to communicate their current efforts if they have met with a health coach. They will also be more confident in opening up to the physician if they discuss potential questions with a coach first.
Studies have demonstrated coaching’s impact in the successful treatment and even reversal of chronic conditions. In one study of patients with prediabetes,5 nearly half of participants returned to normal blood glucose readings following a 14-week personalized coaching intervention. Research also suggests that coaching support makes it more likely that people will successfully lose weight and increase exercise, lower stress, improve lipid markers, decrease blood pressure, and improve diet.
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