Beyond the corner drugstore

The role of the pharmacist is evolving beyond dispensing medication to addressing the increased intricacy and cost of supporting the wellness of the country’s aging and diverse population. There is growing demand for pharmacists to have direct patient interaction in settings such as medical clinics and offices, hospital ambulatory sites and community clinics.

“A strong working relationship between pharmacists and physicians is necessary to optimize personalized care. This team-based holistic approach, or collaborative care model, prioritizes patient safety, improves outcomes and helps reduce costs,” says Joyce Yu-Chia Lee, UCI health sciences clinical professor.

No other healthcare professional has more extensive training in medications and safety than pharmacists, who serve as the medication experts on interdisciplinary teams involving doctors, nurses and other professionals. Pharmacists are uniquely qualified to manage medications, both individually and in combinations from numerous prescribers.

The ability to coordinate the patient’s complete regimen allows the pharmacist to ensure methods for accurate and effective dosage; discuss medication safety; identify and address possible side effects; and assist in managing chronic health conditions. While pharmacists are addressing those needs, doctors can optimize their workloads by spending more time with patients for thorough physical assessment and diagnosis.

“Having different experts addressing the patient’s needs delivers more targeted, less generalized care. When the team comes together, they put together a personalized plan,” Lee says. “My 5-year-old son has the DC superheroes book, and the last page ends with the statement, ‘Superman is strong, but together with the other DC superheroes, he is stronger.’ I associate the collaborative care model with this statement a lot.”

Community-centered implementation

Collaborative care programs have consistently been shown to improve health outcomes and to be cost-effective, and have been implemented in clinics, health centers, hospitals and retail pharmacies across the U.S. for more than a decade, under state-specific regulations. Lee says that this type of arrangement is more prevalent in health systems that have collaborations with pharmacy schools like UCI, because they understand how to engage pharmacists to add value to the organization.

Since arriving on campus in 2020, Lee launched the first pharmacist-led comprehensive medication management clinic at the UCI Health Family Health Center in Anaheim, where she works collaboratively with the care team to optimize medication use among patients with chronic diseases. “There are so many possibilities for implementing this approach,” she says.

In most retail settings today, patients pick up their prescriptions and engage with different pharmacists, who can also offer health and wellness services or chronic disease monitoring when needed.  Patients can also schedule in-person or teleconference visits with their pharmacist when closer monitoring is required for therapeutic effectiveness, medication adherence and other interventions. These interactions with the retail pharmacist help enhance communication between patients and their providers.

In hospitals or outpatient clinics that don’t have a clinical pharmacist on board, Lee says that doctors can work with retail pharmacists to help ensure medication adherence, while monitoring the safety and effectiveness of prescriptions, over-the-counter medications and supplements that a patient may be taking.

In her recent study, Lee found that after community pharmacists receive training to collaborate with doctors in providing direct care, patients experienced improved clinical outcomes and quality of life. This team-based approach is particularly effective for individuals with chronic conditions such as diabetes, hypertension or heart failure, which require close monitoring or rely heavily on medications and self-care. It is also effective for underserved populations or for those who live in rural areas where doctors‘ offices and hospitals are many miles away.

“Introducing new healthcare professionals can also introduce new possibilities for care management,” Lee says. “Many people aren’t aware that pharmacists can go past the traditional role and venture beyond the retail stores. Collaborative care is possible.”

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