Pharmacists Have a Critical Role in Patient Brain Health

Caroline Carney, MD, MSc, FAPM, CPHQ, CMO of Magellan Health, discusses how pharmacists can be first line in noticing changes in patients’ cognitive functioning.

Pharmacy Times® interviewed Caroline Carney, MD, MSc, FAPM, CPHQ, CMO of Magellan Health, on some of the issues surrounding the understanding of mental health and brain health today.

Alana Hippensteele: What is the value of the pharmacist in the field of brain health today?

Caroline Carney: I think the pharmacist can play a critical role in brain health. So, I have a couple of different scenarios that I'm going to share to try to get that point across.

The first is in the circumstance of say a community pharmacist where someone had been going in and seeing that pharmacist to pick up their regular medications or their regular over-the-counter treatments. The pharmacist might often be the first in line to notice a difference in that person. Is the person forgetting to pick up their medications? Are they acting confused about the bottles that they're getting? Are they not refilling the medications when the time for a refill has come due? Those are all signs into something happening perhaps with that individual. So, the pharmacist might be very first line in seeing that.

In an age where we've moved away from often community pharmacists to mail order pharmacy or automatic refills, and there's not that connection, using big data can help us understand many of those same things. So, if I can see someone who has consistently been filling their medications and they don't anymore, as a health plan professional, for instance, I could target individuals and do outreach to individuals who I might have concern about just based on what we can see in data alone in interactions with pharmacists.

Pharmacists are often first line also in providing education about the effects of medications and can do counseling around the dangers or the risks of certain medications. There was a recent study called the D-PRESCRIBE study that showed that pharmacists did a great job in educating and reducing the risk of harm from medications that can be dangerous, like benzodiazepines and opioids.

Finally, measures that [Centers for Medicare and Medicaid Services] is using to look at medications that can cause cognitive decline, particularly in older persons, are metrics that pharmacists are looking at as well, and can help sort through the effects of medications, again like benzodiazepines, anticholinergics, muscle relaxants, or opioids, and the extreme risk that those can all have for brain health, both in direct effects on the brain and in the kind of health-related consequences for individuals who are taking those medications, like falls, motor vehicle accidents, and that kind of outcome.