8 Debilitating Diseases: How Pharmacists Can Help

A list of the most debilitating diseases a patient may face over his or her lifetime was recently curated by Healthcare Business and Technology.

A list of the most debilitating diseases a patient may face over his or her lifetime was recently curated by Healthcare Business and Technology.

Read through the following list to find out how pharmacists can help patients confronted with these challenging conditions:

1. Rheumatoid arthritis (RA)

This autoimmune and systemic inflammatory disease affects around 1.5 million adults, according to the US Centers for Disease Control and Prevention (CDC).

Writing previously for Pharmacy Times, Suzanne J. Francart, PharmD, BCPS, CPP, provided an overview of how pharmacists can help patients with RA who are likely taking non-biologic disease-modifying antirheumatic drugs (DMARDs), glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, or other non-pharmacologic treatments such as physical and occupational therapy.

For example, Dr. Francart recommended that pharmacists ask patients to demonstrate how they would perform subcutaneous injections and provide instructions on hypersensitivity reactions and signs of infection while on treatment.

In an article for Pharmacy Times, Guido R. Zanni, PhD, listed a few additional counseling points for pharmacists with patients who have rheumatoid arthritis, which include addressing patients’ fears of becoming disabled, emphasizing the importance of monitoring the disease, and dispelling misconceptions (eg, “only expensive biologics can help”).

Dr. Zanni also suggested informing patients that early and aggressive intervention can lessen RA’s consequences.

2. Schizophrenia

Around 2.4 million adults in the United States have schizophrenia, a chronic and disabling brain disorder, Makis Papataxiarchis, MBA, PhD, wrote in Pharmacy Times.

According to Dr. Papataxiarchis, pharmacists can provide patient education, monitor medication, and administer injections (depending on the state where the pharmacist practices). For patients taking long-acting atypical injectable antipsychotics, a community pharmacy may be a more comfortable and convenient place for patients to have the treatment administered, and the pharmacist can help the patient with adherence to their medications.

3. Chronic obstructive pulmonary disease (COPD)

Pharmacists should emphasize regular, repeated intervention to patients with COPD, Kimberly Henderson, MD, JD, recently told Pharmacy Times.

Dr. Henderson recommended that pharmacists regularly ask COPD patients if they are complaint with their medications and if they have any questions about their treatment. She also noted that pharmacists can remind patients to take their medication regardless of whether or not they feel sick.

“Intervention only tends to make a difference if the intervention is done again and again and again,” Dr. Henderson said.

Pharmacists can also help with smoking cessation and promoting the flu vaccine among COPD patients.

COPD was the third leading cause of death in the United States in 2011, according to the CDC.

4. Cystic fibrosis (CF)

This chronic and progressive disease affects the body’s mucus glands and can cause respiratory and digestive system problems. Cystic fibroisis can also affect a patient’s sweat glands and reproductive system, according to the CDC.

Writing previously for Pharmacy Times, Matt Lamm, PharmD, MS, BCPS, and Jennifer Barrow, PharmD, said pharmacists can help improve the care of CF patients as medication regimens become more complex.

“Ensuring that current guidelines are followed, counseling to improve patient adherence, and managing drug shortages for key agents are just a few of the ways that pharmacists can have a positive impact for patients with cystic fibrosis,” they wrote.

Some goals for CF patients include decreasing the number of pulmonary exacerbations and preserving current lung function, Drs. Lamm and Barrow noted.

5. Scleroderma

Also known as systemic sclerosis (SSc), this is a symptom of a group of diseases that lead to abnormal growth of connective tissue, according to the National Institutes of Arthritis and Musculoskeletal and Skin Disease.

Patients with scleroderma experience hard, tight skin. In some cases, their internal organs and blood vessels may also degenerate.

Patients with scleroderma often die due to issues with lung function, such as pulmonary fibrosis or interstitial lung disease, Jeannette Y. Wick, RPh, MBA, FASCP, wrote in Pharmacy Times.

Pharmacists can counsel SSc patients to exercise, consider physical and/or occupational therapy, and avoid vitamin C doses >1000 mg per day. Scleroderma patients may also benefit from small yet frequent meals instead of large, spread-out meals, Wick wrote.

In addition, pharmacists can help answer questions about topical moisturizers, corticosteroids, and antifibrotic agents.

“Patients with SSc often have serious, complex complications,” Wick noted. “Pharmacists’ drug expertise is critical for these patients, who often take many drugs.”

6. Multiple sclerosis (MS)

Signs and symptoms of this neurological condition include muscle weakness, difficulty with balance, and eye problems, such as blurred or double vision, according to the National Institutes of Neurological Disorders and Stroke.

Over their lifespan, MS patients may have a hard time walking or standing, and they may experience partial or complete paralysis.

High-dose corticosteroids are a mainstay treatment for acute attacks, while beta interferons and glatiramer acetate are considered first-line for relapsing forms of MS, according to Ashley Hillman, PharmD, BCPS, and Farah Khorassani, PharmD, BCPS.

The ABC-R therapy of MS is: Avonex (interferon b-1a), Betaseron (interferon b-1b), Copaxone (glatiramer acetate), and Rebif (interferon b-1a), Drs. Hillman and Khorassani noted.

As David M. Suchanek, RPh, wrote in Pharmacy Times, pharmacists should research MS and find solutions for their patients who may be confronted with complex clinical regimens and expensive medications.

“As pharmacists, we need to be informed to help manage the uniqueness of each patient…There is huge opportunity for those pharmacists who make the effort, do the research, and find solutions for their customers,” Suchanek wrote. “Managing MS is much more than traditional pharmacy and a business opportunity. It is providing extra care and attention to those patients who need our help the most in their time of need.”

7. Parkinson’s disease (PD)

The 4 major symptoms of Parkinson’s are tremor, rigidity, bradykinesia, and postural instability.

A common treatment for Parkinson’s is levodopa combined with carbidopa, according to the National Institutes of Neurological Disorders and Stroke. Anticholinergics can also help with tremor and rigidity, and drugs such as bromocriptine, pramipexole, and ropinirole can mimic the role of dopamine in the brain.

Amantadine may also reduce symptoms, while other patients may be prescribed rasagiline along with levodopa.

Jeanette Y. Wick, RPh, MBA, FASCP, noted that patients with PD can be frequent pharmacy customers over a long period of time because of the slow and chronic nature of the disease.

“Pharmacists need to be particularly vigilant about medication interactions and ensure dosing changes are gradual rather than abrupt,” Wick wrote. “They should also ask often about swallowing difficulties and offer alternatives when patients begin to have difficulty with oral medications.”

8. Alzheimer’s disease (AD) and dementia

Around 5 million Americans had Alzheimer’s in 2013, and the number of those with the disease doubles every 5 years after age 65, the CDC estimates.

Yvette C. Terrie, BSPharm, RPh, highlighted a few ways in which pharmacists can help Alzheimer’s and dementia patients who struggle with thought process and memory.

“Pharmacists can be a vital resource for both patients and their caregivers, thereby improving quality of life,” Terrie wrote. “A comprehensive understanding of the etiology, pathophysiology, and stages of AD, as well as pharmacologic therapy, is imperative to provide effective care to the patient.”

Beyond medication monitoring for drug interactions and contraindications, Terrie said pharmacists can play a role in educating patients about new developments and resources. Pharmacists should also show empathy toward Alzheimer’s patients and can even suggest memory aids or exercise routines, Terrie noted.