Embracing artificial intelligence and other tools will be necessary to push the field forward.
"I trust you as much as my own doctor” is a statement increasingly heard by pharmacists as patients are recognizing the ease of access and valuable role of the community pharmacist for their health care needs. Pharmacy was once a profession that required only a bachelor’s degree and focused primarily on the dispensing of medications, but with the production of new vaccinations and medications in recent decades, the pharmacist’s role has been revolutionized. This expanded role calls for updates to the extensive curriculum necessary for a doctor of pharmacy degree as the first professional degree and a new understanding of what exactly pharmacists can provide.
Over the past 20 years, pharmacists have continued to expand their scope of practice beyond dispensing by providing new services such as medication therapy management (MTM), immunizations, and point-of-care testing. The value of expanding the clinical role of the pharmacist was highlighted during the COVID-19 pandemic, when pharmacists cemented their role as a vital part of the health care team by answering the call and administering nearly 70% of all COVID-19 vaccines,1 as well as providing other services, such as testing for the virus. Now the only question is: What comes next for the role of the community pharmacist, and how can it be achieved?
Adam James, PharmD, is manager of immunization and clinical programs at Rite Aid, where he provides updates, education, and best practices on changes in policies, procedures, and recommendations.
Shelby Close, PharmD, is a Rite Aid manager in McKees Rocks, Pennsylvania.
By 2050, the world population is projected to increase to an astounding 10 billion people, with the number of individuals aged 60 years and older expected to triple.2 By 2030, the US will face a shortage of more than 125,000 physicians, which could affect care for the more than 60% of individuals with 2 or more chronic health conditions. In addition, life expectancy in the US continues to increase, meaning more physicians will be needed as the older population increases.3 Pharmacists will be able to ameliorate this physician deficit by providing point-of-care testing, preventive care, and even by prescribing. Community pharmacies are the front door to health care, and approximately 90% of Americans live within 5 miles of one.4 However, the pandemic revealed that the conventional pharmacy system of relying on pharmacists for to manually fill prescriptions is a model of the past that must advance in order to benefit the larger health care ecosystem.
The demand for clinical pharmacists is more prevalent than ever. Since the introduction of MTM and development of immunization training programs in the early 2000s, which helped pave the way for the current model of the clinical pharmacist,5 pharmacists have been ready to accept the expanded role. According to CDC data, nearly 38 million influenza vaccines were administered by an estimated 57,000 pharmacies in the United States during the 2023-2024 influenza season.6 In addition to vaccines, community pharmacists completed more than 2 million more MTM claims than in previous years. Sixty percent of Medicare beneficiaries are on a performance-based pharmacy payment plan, which relies on the engagement of pharmacists through MTM to improve quality measures. This need for clinical engagement amplifies the valuable impact pharmacists have on the health system.5
Furthermore, recent changes in state legislation also reflect the need for more clinically oriented pharmacists. Fifty-five bills expanding the capabilities of the pharmacist were passed and signed into law across 32 states in 2023, supporting efforts to allow pharmacists to assist with the future shortage of physicians. Featured in the passage of bills is the ability of pharmacists to provide HIV preexposure prophylaxis and services for sexually transmitted diseases, as well as contraceptive prescribing, broad-spectrum antibiotics prescribing with physician collaboration, expanded payment for pharmacist services, and provider status.7
To support the expansion of the pharmacist’s authority and responsibilities, the workplace must evolve to assist pharmacists and pharmacy teams with the change in duties. Pharmacies will need to enhance workflow by incorporating more advanced automated systems, embracing artificial intelligence (AI), creating call centers, and increasing central fill capacities to reduce the workload of less-clinical tasks, allotting more time for clinical services.
For instance, AI can analyze a patient’s medication history to create personalized therapy regimens, be incorporated into pharmacy smartphone applications to assist with medication queries, and help control inventory management, which may result in reduced errors and unnecessary costs. In turn, these improvements can increase the productivity of pharmacy personnel by managing time slots to ensure the highest quality of care is being provided to each patient without interruption. In addition, interoperable software advances are needed to allow for all members of a patient’s health care team to easily access the information and effectively communicate to drive positive patient outcomes.8
Lastly, the current pharmacy model, mainly consisting of rows of medication shelves, will need to expand into a patient-centered atmosphere with counseling rooms and designated areas for clinical services. These changes, combined with the foundation of providing medications, nutritional supplements, medical supplies, convenient drive-through services, ease of access, and potentially virtual care, will reframe pharmacies as the ultimate wellness destination.
Rite Aid is one example of how clinical services have expanded in recent years with increasing demand and changing legislation. Over the past few years, programs such as point-of-care testing, travel health, and oral contraceptive prescribing have been launched in many Rite Aid stores. The immunization program has expanded largely following the COVID-19 pandemic. A vaccine scheduler was created to manage the influx of patients seeking protection, streamlining the vaccine process for both patients and pharmacy teams. It has now expanded to include the option to schedule clinical services. Immunization centers have been created and are spaced throughout the company regionally, with locations designed to have a dispensing pharmacist along with a separate clinical pharmacist dedicated to providing immunizations and other clinical services to patients.
Over the next 10 to 20 years, community pharmacies are expected to drastically change the way pharmacists operate day to day. Not only will the clinical nondispensing roles increase, but so will the relationships between pharmacists and patients. Regardless of what the future may hold, pharmacists will always remain committed to the profession’s oath of improving knowledge, embracing and advocating for change, utilizing skills to prepare the next generation of pharmacists, and sharing an active role in caring for humanity.9
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