All patients present opportunities, but patients who might be considered more challenging due to their condition are often the cases where pharmacists might make the greatest difference
Every pharmacy patient presents challenges and opportunities. Some challenges are more clinical in nature, such as patients who have multiple comorbidities with myriad possibilities for drug-drug or drug-disease interactions. Some challenges are more personal, as some patients might be exhausted, exasperated, and frustrated from difficulty in accessing or navigating a complex health care system.
Certain clinical situations manifest into challenges due to the symptomatology inherent to the condition. In the case of many central nervous system (CNS) diseases, such as dementia, promoting medication adherence and clear communication can sometimes be a challenge. At the same time, however, in addition to our professional mandate of providing high-quality care, opportunities exist.
Pharmacy personnel have the opportunity to create value for these patients and their caregivers. The relative value theorem proposes that relative value involves the sum of price and service multiplied with perceived value, or the experience a patient might have with a product or service. Patients are looking for value that might otherwise be elusive in today’s health care environment.
This might be even more true for informal caregivers of certain patients. Informal caregivers are those who tend to the needs of a patient (often a loved one, but perhaps someone else) without formal pay or recognition and whose daily life burdens have only been compounded by the care they provide. Caregivers for patients with dementia are attempting to optimize the patient’s medication adherence and their quality of life, while facing these patients’ diminishing memory and sense of autonomy.
Smith et al. conducted a study to discern how pharmacy personnel can assist family caregivers of patients with dementia.1 During interviews, these caregivers reported difficulties in maintaining medication and medical supplies, accessing health professionals, and ensuring adherence to prescribed therapies (both pharmacological and non-pharmacological). Caregivers also provided recommendations for future service enhancements, and these were broadly classified as (1) information, such as routine communication to the caregiver; (2) access and communication, meaning availability for consultations using multiple types of media and simplified systems for ordering prescriptions; and (3) future roles, such as helping to ensure that medication refills are timely and providing more consistency in the quality of visits with pharmacy professionals.
When treating a patient, a pharmacist or other health professional is often also providing counsel and care to the patient’s social support network, as well. All patients present opportunities, but patients who might otherwise be more challenging due to their condition are often the cases where pharmacists might make the greatest difference and inroads to ensure a valued relationship.
Additional information about Creating and Managing Value and Human Resources Management Functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.
Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at the Touro University California College of Pharmacy.
Smith, F, Grijseels MS, Ryan P, Tobiansky R. Assisting people with dementia with their medicines: Experiences of family carers. Intl J Pharm Pract. 2015;23(1):44-51.