Celebrating the Pharmacist’s Impact: How Pharmacists Elevate Care in Every Setting

This American Pharmacists Month, Pharmacy Times^® is celebrating the pharmacist’s impact in their communities by highlighting their role in various disease states.

In this interview, pharmacists from various specialties highlight their diverse roles in patient care, including administering immunizations, testing guidance, and prescribing antiviral medications for influenza; supporting medication adherence and optimizing therapy for patients with chronic kidney disease and related conditions; providing clinical expertise and trusted relationships to address both medical and social factors affecting patient health; and collaborating with other health care professionals to ensure safe, effective care across diverse settings.

Regardless of their role, the pharmacist has a significant impact on a patient’s treatment experience, often serving as approachable and accessible health care professionals, educators, and advocates.

Pharmacy Times: What is the pharmacist’s role in your area of expertise?

Marcella Kinaya, PharmD: So, "flu season" is what we kind of refer to it as. It's definitely our time to shine as pharmacists; we don't like that people get the flu, unfortunately, that's just part of being on this Earth, but we definitely love protecting our patients. The number 1 way is definitely by immunizing—flu shots, COVID vaccines—whatever it may be, immunizations definitely help prevent the illness and lessen the severity if taken.

As far as the testing goes, our pharmacists will help the patient self-administer the test. We don't specifically test them and swab them, but [patients] will make an appointment and come visit us through our drive-through locations—just so we're not exposing any germs to our colleagues—and we will walk them through the testing. The test itself, if you want to know a little bit about pricing, costs $29.99. It does have a pharmacist assessment evaluation fee, which is $45 [but] HSA and FSA cover that, so most people have those that help cover that. After the test, should a patient test positive, there is the opportunity for prescribing in certain states—where available—once the pharmacist evaluates their results, we can prescribe medications that will help lessen the severity of their flu.

Sarah Nelson, PharmD: So, as a pharmacist at UPMC Health Plan, I work with patients to ensure compliance with their prescribed medications, especially the medications that they're prescribed for common comorbidities with CKD, like hypertension, diabetes, hyperlipidemia. And so, when discussing medication compliance with patients, I also review medication-specific and disease state education, in addition to the patients' education, I also complete medication profile reviews to identify potential drug-related problems, in addition to monitoring labs for potential dose adjustments. And then lastly, I work with providers to identify patient populations with suboptimal medication use, and recommend opportunities to optimize medication therapy, and again, really look at medications that may need that renal dose adjustment.

Phil Camden, PharmD: You know, I think we're in a unique position as pharmacists to help our members. Of course, we have the drug knowledge, we also have that additional knowledge and things like testing supplies and lab goals...but, as we know, pharmacists are also considered to be among the most trusted health care professionals, so, I think that can lead our members to maybe feeling a little bit more comfortable to disclose some of those social issues that we had talked about earlier. And then, of course, in a managed care setting, we have that ability to impact our members, not just at the population level view, but really on an individual basis, and [we can] kind of hone in and spend that time with a member who might be a little higher risk or have additional needs. So, I would say ultimately, our role is not just to educate on what the medications are, how you should take them, and why they're important, but it's really just to recognize that medications are just one part of getting the patient to their health care goals. It's really important that we also connect our members with appropriate resources that they need to be successful to reach those goals, and that's why we have these bidirectional communication channels at UPMC with kind of those resources that we had talked about earlier.

Jolene Bostwick, PharmD, BCPS, BCPP: Yeah, we see pharmacists in our role as the medication expert on these teams, thanks to our extensive training and education along with board credentials. And when it comes to the integration on the health care team, I want to first highlight collaborative practice agreements (CPAs), since this allows a BCPP to manage medications under a prescriber and can increase the capacity to serve more patients. Depending on the agreement, this may include prescribing medications and allows pharmacists to make changes at the point of care versus having the prescriber to make these changes later, which can significantly reduce prescriber burden and minimize delays and needed adjustments. Some states even allow pharmacists to hold Drug Enforcement Administration licenses to prescribe medications for opioid use disorder, and this impact could be absolutely incredible considering only about 11% of the 2.5 million Americans with opioid use disorder receive medication treatment.

And further, I want to highlight an important model for the practice of collaboration and comprehensive medication management, which is psychotropic stewardship. This is based on the concept of antimicrobial stewardship programs, which of course many of us are familiar with. And we've developed the concept of psychotropic stewardship, which promotes a safe and appropriate. use of psychotropic medications. AAPP, our organization, envisions that every patient with a psychiatric diagnosis will have their medication treatment plan reviewed, optimized, and managed by a psychotropic stewardship team with a psychiatric pharmacist as a coleader.

And then finally, as part of this team, BCPPs are often referred patients with complex comorbidities, treatment nonresponse, or those experiencing adverse effects from their medication regimen. We, of course, have the knowledge, experience, and understanding of other disease states to help support the whole patient and deliver care through various mechanisms across a variety of settings. You can find diverse delivery of care models and their impact on our website at AAPP.org, which highlights practice profiles of BCPPs who are supporting providers in primary care, reaching patients through rural areas through telehealth or in clinics managing medications for opioid use disorder among many others.