Fred M. Eckel, RPh, MS, Pharmacy Times Editor-in-Chief
Mr. Eckel is professor and director of the Office of Practice Development
and Education at the School of Pharmacy, University of
North Carolina at Chapel Hill.
When a group of North Carolina pharmacy
leaders met in 1994 to advance the role of the
pharmacist, few would have dared to dream
that the Asheville Project would be the result.
Even fewer would have been willing to suggest the impact
it would have on the profession. Today, 10 years after the
project was launched, almost everyone mentions Asheville
when speaking about the pharmacist’s contribution to
patient care. Many states can identify examples of the
Asheville Project being conducted within their borders,
and increasingly, self-insured employers are showing interest
in applying the model to programs of their own.
Now, with 10 years of experience collaboratively managing
chronic disease, what can we learn from this effort?
Motivated Pharmacists Forge Change
Change is difficult, and changing a profession can sometimes
seem a daunting task. The Asheville Project and its
many follow-up programs show that change is possible and
highlight the critical role pharmacists can play in the management
of chronic disease. In Asheville, a change in mindset
was achieved when those original pharmacist pioneers
put the needs of others—especially patients—first. Rather
than focusing on “what’s in it for me,” they asked “how can
I make a difference,” and they did.
We learned that motivated pharmacists—with encouragement,
resources, and the right structures—are
capable of collaboratively coaching patients to manage
their own chronic disease. Pharmacists who want to do it
can be prepared to do it. They may need a little training.
They need a structure to work within so that referrals are
possible and patient information can be shared. The pharmacist
serves more like a personal trainer for the patients,
so that over time, patients begin to take the responsibility
to manage their own disease.
Rather than encountering turf battles between professionals,
we learned from the Asheville Project that when
pharmacists assume a collaborative role in chronic disease
management, the role of other professionals is enhanced.
The results are better disease management than what any
one professional could do alone.
We hear each year how much pharmacists are trusted
by the public. The Asheville Project demonstrates that
patients do trust their pharmacist and are very satisfied
with the care they receive.
The Personal Connection
The Asheville Project is based on face-to-face interaction
between the pharmacist and the patient. The long-term
success of this project suggests that this personal interaction
is important in developing trust, holding people accountable
for agreed goals, and monitoring that outcomes are
achieved.
Why has the Asheville Project had such staying power?
A program started locally, involving local providers with
support from community leaders, may well be the key.
We hope this special issue highlighting yet more examples
of effective disease management efforts will help you
get started offering your own program. Remember: change
comes when a few individuals feel like they can make a difference.
Will you be one of those few?