The Pharmacist’s Expanding Role in Chronic Disease Management

Chronic diseases remain the leading cause of death and disability in the United States and are the predominant drivers of health care spending.¹ More than 129 million Americans—over half the population—live with at least 1 major chronic condition, often with overlapping comorbidities that complicate treatment and long-term outcomes.² Approximately 90% of the nation’s annual health care expenditures are attributable to the management of chronic physical and mental health conditions.³ Chronic diseases such as diabetes, hypertension, cardiovascular disease, asthma, and chronic obstructive pulmonary disease (COPD) place a significant burden on health care systems due to their long-term nature and complex medication regimens.

Managing chronic diseases effectively requires care that extends beyond occasional physician visits, and pharmacists are positioned to help deliver that ongoing support. Pharmacy practice has shifted from a traditional role of dispensing medications to a patient-centered approach that prioritizes optimizing medication use, counseling patients, preventing and managing drug-related issues, and advancing public health.

Expanding the Scope of Practice in Chronic Disease Care

The emergence of the pharmaceutical care model in the early 1990s marked a turning point for pharmacy, redefining it from a dispensing-centered profession to one centered on patient care and medication safety.⁴ Growing evidence has shown that pharmacists are integral to chronic disease management by conducting clinical assessments, engaging with patients, optimizing therapies, and working collaboratively with other health care professionals.⁵

A recent systematic review of clinical pharmacy services revealed significant benefits in the prevention, monitoring, and management of chronic illnesses, with improvements in treatment effectiveness, reduced medication-related problems, and enhanced overall patient outcomes.⁵ These developments demonstrate how pharmacists have evolved from mere dispensers to critical health care professionals who actively manage chronic diseases and promote patient well-being.

Screening and Early Detection

Community pharmacists are among the most accessible health care professionals, making pharmacies an ideal setting for the early detection of chronic diseases. Pharmacist-led screening programs have been effective in identifying previously undiagnosed conditions, including hypertension, diabetes, asthma risk, and COPD, providing patients with timely access to evaluation and care. These initiatives also reach individuals who may not routinely see a primary care provider, enhancing opportunities for early diagnosis and intervention.

In addition to performing formal screenings, pharmacists play a crucial role in identifying and managing risk factors during everyday patient interactions. This may involve monitoring elevated blood pressure, optimizing inhaler technique, offering smoking-cessation support, identifying medication nonadherence, and addressing lifestyle or medication-related concerns.

Medication Therapy Management and Comprehensive Medication Review

Medication therapy management (MTM) and comprehensive medication management (CMM) are essential components of high-quality chronic disease care. Patients with multimorbidity and polypharmacy face heightened risks of drug-drug interactions, therapeutic duplication, inappropriate dosing, and nonadherence. Pharmacists’ advanced training in pharmacotherapy positions them to identify, prevent, and resolve these medication-related problems through structured, evidence-based interventions.^6-8 Comprehensive medication reviews conducted by pharmacists have demonstrated meaningful clinical benefits, including reductions in hospital readmissions, improved disease control, enhanced medication safety, and greater adherence to evidence-based therapy.⁹

As part of MTM and CMM services, pharmacists regularly reconcile and streamline complex medication regimens; identify and address drug-related problems, including adverse effects and therapeutic duplications; support deprescribing when clinically appropriate; monitor laboratory results and clinical outcomes in chronic disease management; and collaborate with prescribers to optimize therapy and maintain continuity of care. These interventions support safer, more effective long-term medication use and improve outcomes for patients with chronic conditions requiring multidrug regimens.⁹

Interprofessional Collaboration and Integrated Care Models

Chronic disease management is inherently multidisciplinary, requiring coordinated contributions from physicians, nurses, dietitians, and other health professionals. Pharmacists enhance health care teams by offering specialized expertise in medication management, proactively identifying and resolving drug-related issues. Collaborative practice agreements allow pharmacists to initiate, adjust, or monitor medications under an approved protocol with a physician. This expanded role helps streamline care and ensures patients receive consistent, effective treatment.

Moreover, physicians generally support pharmacist involvement in chronic disease care. Integrated care teams that include pharmacists have been associated with better clinical outcomes, improved coordination of care, enhanced communication among providers, and greater satisfaction for both patients and clinicians.¹⁰

Public Health Contributions

Pharmacists are well positioned to promote public health through their frequent interactions with patients and their integral role in the community. They contribute to immunization programs, smoking cessation support, risk-factor reduction, and general health promotion, all of which help prevent and manage chronic diseases. Research findings indicate that pharmacist-led efforts such as vaccination campaigns, lifestyle counseling, and health screenings improve disease prevention, increase health literacy, and reduce long-term complications, ultimately supporting better population health.¹¹

Economic and Health System Impact

Pharmacist involvement in chronic disease management benefits both patients and the health care system across multiple domains. Clinically, it helps manage chronic conditions by improving key laboratory markers, enhancing disease control, and supporting better long-term health outcomes. From a humanistic perspective, it promotes medication adherence, enhances patient understanding, and increases satisfaction with care. Economically, these interventions reduce hospitalizations, limit complications, and optimize health care resource use, reinforcing both efficiency and sustainability in the health care system.¹²

Barriers to Full Implementation

Despite their proven benefits in chronic disease management, pharmacist-led services are not fully adopted due to several challenges.¹³ Limited reimbursement and unclear scope of practice often restrict pharmacists’ ability to provide clinical care. Inadequate access to shared health records and low awareness among patients and other health care providers further limit their integration into care teams. Expanding continuing education, professional development, and supportive policies is crucial to fully realize pharmacists’ potential in patient care.

Pharmacists are essential in managing chronic diseases, delivering clinical expertise, personalized care, and ongoing support to improve patient health outcomes. They optimize medication regimens, address drug-related problems, and educate patients to enhance adherence and prevent health complications. By collaborating closely with health care teams, pharmacists help ensure care is coordinated, effective, and patient centered. Their contributions directly improve patient health while supporting the overall efficiency and quality of the health care system.

About the Author

Anjeza Fero, PharmD, RPh, is a pharmacist and professor at the University of Connecticut School of Pharmacy in Storrs.

REFERENCES

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