An appointment with the pharmacist

April 15, 2012

Because pharmacists are making a measurable difference in the outcomes of their patients, their roles as providers are changing. There are some barriers, however.

So why are patients making appointments with the pharmacist? The list of reasons is growing. Pharmacists play an ever-increasing role in chronic disease management and are key providers in delivering education, accountability, and diagnostic screenings that assist in improving outcomes and lowering overall healthcare costs. According to the Pharmacy Digest, 78% of independent community pharmacies indicated they offer at least 1 disease state management service or medication therapy management (MTM) service, with the No. 1 clinical service being immunizations. From diabetes education to immunizations and MTM consultations, pharmacists are making a measurable difference in the outcomes of their patients by offering a service-based approach to care.

A landmark 2010 New York Times article, 'In Health Shift, More Patients get Pharmacist's Appointment,' highlighted the increase in patient appointments with pharmacists and its impact on healthcare. The article named several health organizations, such as the UnitedHealth Group, Humana, and Medicare, utilizing pharmacists to lower healthcare costs. One recent study published in The Annals of Pharmacotherapy in December 2011 showed that patients who received care that included pharmacist involvement had adjusted A1c levels reduced, on average, by 1.38 percentage points compared to those who didn't. This is a clinically meaningful improvement, making it 3 times as likely for patients to achieve an A1c level of < 7%, the typical treatment goal in the study.

While studies show the health outcomes and financial benefits of meeting with a pharmacist, several barriers exist for expanding these services. First, a majority of pharmacies lack an easy way to highlight their clinical services. A "menu of clinical services" is not typically posted within the walls of the community pharmacy, creating an interesting paradigm of patients who are unaware of vital clinical services that are available in their neighborhood drug store.

This barrier can be overcome with the use of a new online program that provides a searchable database for clinical pharmacy services. The website, http://PharmacyForward.com/, allows patients to search for services in their area, such as immunizations, diabetes education, and blood pressure screenings. The site also allows pharmacists to set their available schedule for each service provided, allowing the patient to schedule an appointment.

Another barrier to overcome involves reimbursement for pharmacists. Fortunately, multiple third-party entities, including Medicare, cover several pharmacy services. Immunizations, MTM, and diabetes self-management education, for example, are billable services by a pharmacy. Several pharmacy groups, such as the American Pharmacists Association and NCPA, have created programs that explain how to create these offerings within the community setting, including education on standard billing procedures and accreditation requirements. These programs are vital to pharmacists engaging in this emerging market.

The pharmacy landscape is rapidly changing to include service-based approaches that are proving to be a major factor in healthcare reform. Pharmacists face a unique opportunity to embrace the role of a "primary-care pharmacist" as described in Project Destiny (for more information, visit http://NCPAnet.org/) while maintaining their role as the purveyors of medicine.

As the nation increases in age and chronic disease rapidly grows, the "medication expert" is needed more than ever to improve outcomes and be a catalyst for change in today's healthcare system.

David Pope is the chief of innovation and co-founder of the http://CreativePharmacist.com/ brands. He can be reached at david@CreativePharmacist.com