CONSULTANT PHARMACISTS PLAY IMPORTANT ROLE IN LONG-TERM CARE

ADVANCEMENTS IN MEDICAL care over the past 30 years, coupled with a growing emphasis on a healthier lifestyle, have resulted in more adults living longer?the US population aged 65 years and older is expected to double within the next 25 years. By 2030, almost 1 out of every 5 Americans?some 72 million people?will be 65 or older. The elderly population also consumes a considerable amount of prescription medications; in 2005, they used 37% of all US prescriptions.

This population needs more than just medications; they need expert advice on how to take them, as well as an advocate to make sure the medicines they receive are right for them. The consultant pharmacist is specially trained to assist with long-term care patients with their special medication needs. Consultant pharmacists can influence a prescriber?s decisions regarding senior patients based on their expert recommendations and personal interaction with the patients.

Seniors are at a greater risk for medication-related problems than other populations, chiefly because of the various physiological impacts of aging, a higher rate of multiple chronic diseases, and a greater consumption of both prescription and OTC medications. The consultant pharmacist is vital in making sure this population receives the proper care for any adverse events that might occur due to a medication mishap.

Although the majority of long-term care patients are elderly, consultant pharmacy is not limited to this population. Consultant pharmacists also work in mental institutions, hospice care facilities, correctional institutions, and acute care hospitals. Since most of the settings where consultant pharmacists practice are predominantly populated by older adults, however, a broad understanding of geriatrics, especially geriatric pharmacotherapy, is important for the potential consultant pharmacist.

The roles of the consultant pharmacist are as varied as their locales. Not only do they administer pharmacy services, but they also educate both patients and other health care providers on various medical issues of importance to the long-term care patient. They also can provide advanced services, such as disease management protocols, software development, laboratory services, nutrition services, and clinical research to any number of different care settings.

Brian Wolstenholme, PharmD, is a consultant pharmacist in Miami Shores, Fla. He landed his first job as a consultant pharmacist in 2002 through Omnicare, a top provider of pharmaceutical care for residents of nursing, assisted living, and other health care facilities. He said he got into consultant pharmacy because he wanted to be involved in something more clinical than retail pharmacy. He recommended that students interested in consultant pharmacy should get involved with a consultant pharmacist rotation in their school, if available, so that they can get a true feel of what the work is like. Some states require that consultant pharmacists obtain a separate license; he says that getting this license is important before reaching out to potential employers and to be sure of what each state?s requirements are.

Dr. Wolstenholme currently works with several different nursing homes in Florida, caring for about 1000 patients?about 60 beds a day. He said that a vital part of the job, almost as important as clinical skills, is time management skills and flexibility. He also stressed the value of communication skills. ?You are not working with just patients [in the nursing home environment]?you have to deal with [many other] key players in the interdisciplinary health care team,? he said.

Dr. Wolstenholme is a member of the American Society of Consultant Pharmacists (ASCP), the professional group that offers education, advocacy, and resources to help promote consultant and senior care pharmacy. To take advantage of all the ASCP has to offer, visit www.ascp.com. A well-informed, properly equipped consultant pharmacist is a valuable asset in protecting the health and quality of life for senior patients.