The Role of the Pharmacist
Clinical pharmacy services foster population-based health and wellness through comprehensive services provided to patients and other health care providers that include drug information, disease management, disease self-management education, lifestyle and behaviorial counseling, and formulary management. Disease prevention is a priority in pharmaceutical care through provision of immunizations, tobacco cessation counseling, substance abuse education, and partnership with patients through medication therapy management (MTM) programs that ensure safe and effective medication use that optimizes therapeutic outcomes and healthy lifestyle behaviors to prevent the risk and burden of disease and injury.
Examples of Transformational Change in Pharmacy Practice
Below are highlights of the important role pharmacists play in improving population health:
Vaccination Program: Pharmacists providing a vaccination program at Saint Luke's Hospital in Kansas City were responsible for screening patients for indications and contraindications to pneumococcal and influenza vaccinations, counseling patients, and contacting the physician for a vaccination order when indicated. 
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In addition, the pharmacy computer system was used to track patients who were screened and immunized. Vaccination rates increased significantly from 56.1% to 73.8%. The number of pneumococcal vaccines dispensed each year quadrupled. In addition, the immunization-screening rate for patients with community acquired pneumonia met the Healthy People 2010 goal of 90% in the fourth quarter of 2002.
For additional details, please contact ASHP.
Safety Net Clinic: Faculty from the University of Southern California School of Pharmacy partnered with three safety net clinics to assist in purchasing drugs through lower cost 340B programs, organize dispensary formularies to take advantage of free medications from patient assistance programs, and provide disease management services for high-risk safety net clinic patients.
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Initial meetings between the pharmacy team and medical administrators from the three safety net clinics revealed that each clinic was purchasing expensive medications for which low- or no-cost alternatives were available. As a result, the clinics were struggling to manage their patients with diabetes, hypertension, asthma, and dyslipidemia. Through pharmacy-offered services, the clinics saved nearly $700,000 in annual drug costs. In addition, pharmacist care was associated with a reduction in systolic blood pressure of 26 mmHg and diastolic blood pressure of 12 mmHg among hypertension patients and a reduction in HbA1C of 3.7 points from baseline among diabetic patients.
For additional details, please contact ASHP.
Diabetes Care Collaborative Practice: In a randomized study conducted at community health center, pharmacists engaged in diabetes care services, including providing information and responding to patient questions about their disease state, recommending lifestyle changes, encouraging patients to monitor blood glucose levels, and reviewing medications charts. Read more
Moreover, under a collaborative practice model, pharmacists initiated aspirin therapy, administered influenza vaccinations, referred patients for therapeutic shoes, and performed medication evaluations for hypertension and dyslipidemia. The intervention group demonstrated a greater decrease in HbA1c levels compared to the group without pharmacist involvement (p<.005). Patient satisfaction was also improved compared to the control group. Finally, patients receiving pharmacist-managed care met treatment goals more often than patients receiving standard care.
See Scott DM, Boyd ST, Stephan M, et al. Outcomes of pharmacist-managed diabetes care services in a community health center. Am J Health-Syst Pharm. 2006;63: 2116-22.
Health Literacy: Heart failure patients 50 years of age or older with low socioeconomic status and health literacy were randomly assigned to pharmacist-intervention or usual care groups and followed for 12 months. Read more
Among patients who received pharmacist-provided medication management, medication adherence was significantly increased, while emergency department visits and hospital admissions were decreased 19.4% Annual direct health care costs were also decreased in the intervention group.
See Murray MD, Young J, Hoke S, et al. Pharmacist intervention to improve medication adherence in heart failure: a randomized trial. Ann Intern Med. 2007;146(10):714-25.
Relevant ASHP Best Practices
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