Medicine Education: Pharmacists as Providers of Patient Information
I have had the distinct pleasure of working for the National Council on Patient Information and Education (NCPIE), a nonprofit coalition working to improve the dialogue between consumers and their health care providers to promote safe and appropriate medicine use, for almost 30 years. It has been quite an experience, having the opportunity to work closely with national consumer and patient organizations, government agencies, the pharmaceutical industry, and health care organizations representing physicians, physician assistants, nurses/nurse practitioners, and pharmacists engaged in community-, health-system—, academic-, and policy-related practices. Oftentimes these organizations make strange bedfellows when it comes to issues involving health care delivery and finance, and while they cannot always agree that the sun will rise in the morning, they unite for the NCPIE mission of promoting safe medicine use, and are committed to action.
Over the course of my tenure at NCPIE, it has been fascinating to observe the world of pharmacists as the profession has worked diligently to demonstrate its expertise in pharmaceutical care, establishing a role I’ve come to call “the medication counseling expert.” The profession is again working diligently to demonstrate its proficiency, this time by using hard data and better health outcomes to buttress its fact-based contention that pharmacy services not only save lives but save money as well. In addition, the profession has sent itself back to pharmacy school for an advanced PharmD degree, ensuring that the pharmacists of today and into the future are well versed academically and clinically, as they will need be to engaged in direct, collaborative patient care with their multidisciplinary colleagues in medicine, nursing, and social work in today’s landscape of accountable, evidence-based health care delivery.
Let me share some important recent observations that come to mind when I ruminate about pharmacists as providers of patient information and education. In the late 1980’s, NCPIE coined the phrase “medicine education team” to espouse the paradigm needed to ensure high-quality communication among patients, caregivers, and health care professionals regarding medication. In this paradigm, NCPIE placed the patient at the center of the team—a precursor to today’s mantra of patient-centered care. Teamwork requires ongoing, consistent communication, making sure that everyone is informed of any changes in the game plan and passes that information to every team member. In much the same way, high-quality medicine communication requires such teamwork to make sure that every time a prescription medication is being considered as part of a treatment recommendation, or an OTC medicine, dietary supplement, or herbal remedy is selected as part of informed self-care, all members of the medicine education team are informed and are, as needed, doing their part to better ensure safe and appropriate medicine use. Pharmacists are vital players on the medicine education team—accessible, well trained, and skilled at helping ensure that patients and caregivers are equipped to understand and umedications safely and appropriately.
Recently, a convergence of events helped demonstrate the value of pharmacists as providers of patient information and education. In October 2013, NCPIE released a referenced report entitled “Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda.” This report, a 10-step adherence action agenda, places the spotlight on the pervasive and costly problem of poor medicine adherence, particularly among those 65 years and older who have multiple chronic conditions and are at the greatest risk of medication errors, drug interactions, and costly disease complications. The report also identifies numerous behavioral, social, economic, medical, and policy-related factors that contribute to poor adherence in this patient population. This includes the complexity of the drug regimen; the need for patients to visit multiple prescribers and, in many cases, multiple pharmacies to fill different prescriptions; cost-control measures implemented by payers and health systems; poor communication between patients and clinicians; and the breakdown in provider communications during the transition in care from the hospital to the outpatient setting. All of these problems contribute to medication errors, nonadherence, poor health outcomes, and higher health care costs—and all must be addressed.
Among the 10 priorities for action called for by NCPIE in the report, there is one in particular that pharmacists, as medication counseling experts and providers of patient information and education, are eminently qualified and positioned to address: Priority for Action 5: Eliminate the barriers that impede the ability of patients with multiple chronic conditions to refill their prescription medicines.
One of the reasons patients fail to refill their prescriptions is the difficulty of picking up prescriptions at different times and sometimes different pharmacies, a process that may require numerous trips. To reduce these obstacles, stakeholders support implemention of the “pharmacy home” model, which gives patients a single pharmacy point of contact for filling prescriptions, and adoption of refill synchronization, which allows patients to fill different prescriptions at one time and therefore reduce the number of visits they must make to the pharmacy.
Within 12 months of the release of “Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda” by the NCPIE, the American Pharmacists Association (APhA) Foundation launched a national educational campaign entitled Align My Refills. The campaign is designed to teach patients and caregivers how to engage with pharmacists through medication synchronization (med sync) programs to improve medication use and achieve better health outcomes. Med sync programs are especially beneficial for patients taking multiple, ongoing monthly medications; older adults; and patients new to chronic drug therapy. They add value for patients in the form of a regularly scheduled monthly opportunity to meet with their pharmacist to discuss their medications. Through www.alignmyrefills. com, patients can find pharmacies offering a medication synchronization program in their community, as well as helpful information about medication adherence and how the program can help ensure that they stick to their prescription regimen.
NCPIE is pleased to be a named partner with the APhA Foundation on the Align My Refills campaign, and is also pleased to have the following pharmacist/pharmacy organizations serving on our board of directors, helping to determine our programs and services to fulfill our mission: the American Association of Colleges of Pharmacy, the American Pharmacists Association, the American Society of Health-System Pharmacists, the National Community Pharmacists Association, and the National Association of Chain Drug Stores.
In my estimation, pharmacists are indeed the preeminent providers of patient information and education on medication.
About the National Council on Patient Information and Education
Established in 1982, the National Council on Patient Information and Education is a diverse nonprofit coalition that works to stimulate and improve the communication of information about the appropriate use of prescription and OTC medicines. NCPIE’s members include consumer organizations, patient advocacy groups, voluntary health agencies, health professional associations, schools of pharmacy, health-related trade associations, prescription and OTC pharmaceutical manufacturers, and local, state, and federal government agencies. More information about NCPIE is available through its website, www.talkaboutrx.org.
Ray Bullman, MAM, has served as executive vice president of the National Council on Patient Information and Education since 1995. He earned his MAM degree in nonprofit association management from the George Washington University.