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Chain Drugstores: Providing Effective Patient Care and Professional Development

Author: Barbara Sax

The community drugstore has always been the heart of pharmacy. Nearly all Americans live within 5 miles of a community retail pharmacy.

For a vast majority of patients, that pharmacy is operated by a national drug chain. In fact, the National Association of Chain Drug Stores (NACDS) estimates that chain drugstores fill nearly two-thirds of all retail prescriptions.

With pharmacies so accessible to American consumers, it is not surprising that pharmacists are the health professionals patients are likely to turn to first when they have questions about their health. In an overburdened health care system, community pharmacists are playing an even more crucial role in their patients’ health. According to a recent NACDS study, consumers report the least amount of difficulty in accessing health care from a pharmacy. Clearly, pharmacists practicing at chain drugstores have opportunities to be significant players in the health care system and an important health resource for their patients.

“With the alarming growth of chronic disease in the United States, pharmacists can play a very valuable role in health care delivery and in the fight to manage the growth of chronic disease,” said Edith Rosato, senior vice president of pharmacy affairs at NACDS.

Rosato said that more and more, chain pharmacists are assuming the role of patient health coach, working side by side with patients to help increase their understanding of chronic disease and the impact their medications have on mitigating the long-term complications due to disease progression. “Frequent one-on-one sessions between pharmacists and patients have been highly effective in helping patients lead healthier lives,” she said.

“Leveraging the access we have to patients puts community pharmacists in a great position to be effective,” said Jay Nadas, director of retail clinical pharmacy programs at Walgreens. “We, as part of the health professional team, are trying to create behavioral changes with patients, so they can be more involved and aware of their own health management. The most effective way to do that is through developing relationships and listening to their concerns. The best way to develop those relationships is through face-to-face contact with patients and patient advocates.”

Of course, communicating with patients is crucial to effective patient care, and the nation’s top drug chains are committed to improving traditional methods and finding new ways to reach their patients.

Expanding Patient Services

At Rite Aid, for example, pharmacists provide patients with critical information about their medications, make recommendations on OTC products, and counsel patients on how to best manage chronic health conditions with the medications their physicians have prescribed.

“Practicing in a community pharmacy setting gives our pharmacists the opportunity to have direct contact with patients through providing counseling/recommendations on medications and clinical services, such as immunization or MTM services,” said Michele Belsey, RPh, vice president of college and professional relations at Rite Aid. “It also provides direct communication with doctors and care givers. Pharmacists in the drugstore setting use their knowledge to help patients choose OTC therapies and can help provide patients with solutions regarding the economics of medication therapy,” she said.

To train its pharmacists to provide the highest level of care to diabetes patients, Rite Aid has joined forces with the American Diabetes Association as a strategic partner. “Rite Aid pharmacists receive training that goes beyond diabetes, and extends to other serious health conditions such as heart health and weight management,” said Belsey.

CVS is also committed to having its pharmacists play a key role in managing and improving the health outcomes of its patients. The chain invests in both technology and work-flow processes that allow pharmacists more time to focus on the professional aspects of their role. “Our systems and procedures are designed so that our pharmacy support staff handles administrative functions such as insurance adjudication,” said Papatya Tankut, RPh, vice president of pharmacy professional services at CVS.

Focus on Counseling

Like other national pharmacy chains, CVS continues to focus on improving patient service. Last year, CVS completed the rollout of RxConnect, the chain’s new retail pharmacy system, to all CVS/pharmacy locations. “This new system improves the efficiency and productivity of our pharmacy teams with over 200 ease-of-use enhancements,” said Tankut. “The result has been a 15% improvement in processing time spent using the system, and it positions us to add additional in-store programs to enhance patient care.”

In January 2011, the chain launched its Pharmacy Advisor program, which is designed to manage costs, improve adherence, and close gaps in care for CVS Caremark plan members with diabetes. “We can now leverage Caremark’s clinical intelligence and behavioral insights to identify plan members with diabetes who have suboptimal pharmacy care, and provide this information to the members’ local CVS pharmacist so that they can review current treatment and identify gaps in care or issues with medication adherence,” said Tankut. Counseling can be conducted on the phone with a pharmacist or face-to-face at their local CVS/pharmacy, depending on patient preference. The chain plans to add more disease states to the program in the future.

As the needs of their patients change, chains continue to find new ways to reach patients with tools that help them make informed decisions about their pharmacy, health, and wellness needs. “Expanded counseling and disease state management opportunities at Walgreens address immunizations, HIV, diabetes, oncology, transplants, compounding, and even flavoring,” said a Walgreens spokesperson. “In each of these opportunities is the root of what we value in community pharmacy—taking the time to consult with patients to establish a relationship about their care.”

Walgreens now has more than 700 Compounding Centers of Excellence across the country, where specially trained pharmacists can offer medications in a variety of forms, including capsules, lozenges, gels, creams, ointments, and even lollipops, to better meet individual needs. The chain also has nearly 200 HIV Centers of Excellence in communities highly impacted by the condition. “Our pharmacists in these locations see patients on a monthly basis and do a number of adherence checks and community outreach,” said Glen Pietrandoni, manager of specialized disease state programs at Walgreens. “These pharmacies are also fully stocked with HIV medications.”

Reaching Patients Through New Media

Chains are finding ways to use new media to better connect with patients. Rite Aid now offers patients the option to receive automatic mobile text alerts when their prescriptions are ready for refill and pickup. The new service is expected to help patients stay current with their prescriptions and improve patient adherence. It’s also a way to communicate with patients using methods they prefer—a testament to the channel’s commitment to keep pace with its customer base.

Web-based programs allow pharmacists to interact with patients at the patients’ convenience. Rite Aid, for example, recently introduced a service in Pennsylvania offering patients live online interactive consultations with pharmacists at a number of its locations.

Rite Aid Online Care, which can be accessed from home or at select Rite Aid pharmacies, allows patients access to Rite Aid pharmacists who are specially trained in immunizations, diabetes care, and medication therapy management. Through the service, pharmacists can give a full review of medications, offer insights into side effects and interactions, and stress the importance of following a prescribed medication regimen— all during in-depth counseling online.

Another Rite Aid program called “wellness ” is Rite Aid’s customer rewards program, which gives patients access to pharmacists for more general questions around the clock. Through instant online chats, e-mailed questions, and a 24-hour toll-free telephone line, patients have access to pharmacists 24 hours a day on general health questions, drug interactions, and possible side effects.

Reaching the Community

Vaccines are another key area of focus at the nation’s top pharmacy chains. “Flu and pneumonia vaccinations have become commonplace at virtually every pharmacy today, and some pharmacies are implementing expanded immunization programs providing adult vaccines,” said NACDS’s Rosato.

“The ability of our pharmacists to administer immunizations this season was a clear demonstration of the pharmacist’s role evolving from just being a dispenser of products to now being a provider of health care services,” said CVS’s Tankut. “We had at least 1 pharmacist certified to immunize against the flu in every CVS, and we plan to expand that capability for the next flu season.”

More than 6700 Rite Aid pharmacists are certified to immunize patients, and flu and pneumonia shots are offered at Rite Aid locations every year. Tetanus, hepatitis A and B, and shingles vaccines are also available at certain Rite Aid pharmacies across the country, subject to state regulations.

Walgreens continues to expand its immunization services and now offers a wide range of more than 20 Centers for Disease Control and Prevention–recommended immunizations. A network of more than 26,000 certified immunizers have helped Walgreens become the largest provider of flu shots in the United States outside the federal government.

An Opportunity to Build a Career

The country’s major drug chains are focused on maximizing pharmacist/patient interaction to create the best health outcomes. “Our pharmacists have the opportunity to interact with patients, physicians, and care coordinators—all while being able to use clinical background to help make a difference for patients,” said Joel Wright, vice president of health systems operations at Walgreens.

Chains provide pharmacists with the tools they need to serve their patients as well as an opportunity to grow professionally.

“Our pharmacists are not only provided with great technology, but are led by a management team that supports development and community involvement,” said Rite Aid’s Belsey. “With over 4700 locations in 31 states and the District of Columbia, Rite Aid provides flexible scheduling along with the opportunity for progression into executive pharmacy management.”

Pharmacists at a drug chain can move into many different roles. Some pharmacists take a management path in the field, overseeing a growing number of pharmacies as their career advances. Other pharmacists choose to move into corporate roles, which range from operations to clinical services.

“A pharmacist may choose a career path where they can work in one of our other divisions of pharmacy, such as home care, health system pharmacies, or specialty pharmacy,” said Amanda Douglas, manager of talent acquisition and diversity services. Douglas said that many of the chain’s pharmacists working in these settings began as Walgreens community pharmacists. “They bring Walgreens experience while expanding their roles as pharmacists to other practice settings,” she explained. %u25CF



 Ms. Sax is a freelance writer based in Chevy Chase, Maryland.