Mr. Eckel is professor and director of the Office of Practice Development and Education at the School of Pharmacy, University of North Carolina at Chapel Hill.
When a group of North Carolina pharmacyleaders met in 1994 to advance the role of thepharmacist, few would have dared to dreamthat the Asheville Project would be the result.Even fewer would have been willing to suggest the impactit would have on the profession. Today, 10 years after theproject was launched, almost everyone mentions Ashevillewhen speaking about the pharmacist?s contribution topatient care. Many states can identify examples of theAsheville Project being conducted within their borders,and increasingly, self-insured employers are showing interestin applying the model to programs of their own.
Now, with 10 years of experience collaboratively managingchronic disease, what can we learn from this effort?Motivated Pharmacists Forge Change
Change is difficult, and changing a profession can sometimesseem a daunting task. The Asheville Project and itsmany follow-up programs show that change is possible andhighlight the critical role pharmacists can play in the managementof chronic disease. In Asheville, a change in mindsetwas achieved when those original pharmacist pioneersput the needs of others?especially patients?first. Ratherthan focusing on ?what?s in it for me,? they asked ?how canI make a difference,? and they did.
We learned that motivated pharmacists?with encouragement,resources, and the right structures?arecapable of collaboratively coaching patients to managetheir own chronic disease. Pharmacists who want to do itcan be prepared to do it. They may need a little training.They need a structure to work within so that referrals arepossible and patient information can be shared. The pharmacistserves more like a personal trainer for the patients,so that over time, patients begin to take the responsibilityto manage their own disease.
Rather than encountering turf battles between professionals,we learned from the Asheville Project that whenpharmacists assume a collaborative role in chronic diseasemanagement, the role of other professionals is enhanced.The results are better disease management than what anyone professional could do alone.
We hear each year how much pharmacists are trustedby the public. The Asheville Project demonstrates thatpatients do trust their pharmacist and are very satisfiedwith the care they receive.The Personal Connection
The Asheville Project is based on face-to-face interactionbetween the pharmacist and the patient. The long-termsuccess of this project suggests that this personal interactionis important in developing trust, holding people accountablefor agreed goals, and monitoring that outcomes areachieved.
Why has the Asheville Project had such staying power?A program started locally, involving local providers withsupport from community leaders, may well be the key.
We hope this special issue highlighting yet more examplesof effective disease management efforts will help youget started offering your own program. Remember: changecomes when a few individuals feel like they can make a difference.Will you be one of those few?