Closing the communication gap between physicians and pharmacists
Key Takeaways
As a doctor, you are probably feeling the demands of a larger patient census, growing administrative duties, and the rigors of payment—including value-based models, which are based on quality of care. The associated stress is likely to increase with worries about a looming physician shortage. As is, patients often wait weeks for an appointment, with the chief complaint taking center stage and other concerns in the periphery.
With the weight of responsibilities, physicians could use a helping hand. Increased communication and cooperation with pharmacists may be an answer. Pharmacists are highly trained medical professionals with loads of clinical knowledge. Why not leverage their input?
Why pharmacists?
Pharmacists earn a doctorate of pharmacy degree and follow the Pharmacists' Patient Care Process. As bolstered by the AMA, this approach is holistic and incorporates clinical services, lifestyles, functional needs, and more. Pharmacists draw from patient health literacy, cultural background, beliefs, and socioeconomic factors to contribute to a patient-centered care plan.
Pharmacists can facilitate health and wellness promotion and work with underserved populations using wellness-screening programs, self-care, tobacco cessation, vaccine administration, preconception, and management of chronic disease.
Pharmacists have a long history of mitigating social determinants of health (SDOH) in all types of underserved populations. This outreach not only occurs in specialty and community pharmacies but also as part of integrated health networks, managed care/community-based settings, clinics, and hospitals. By means of medication management and patient education, pharmacists can also help with transitioning care following hospitalization, thus avoiding rehospitalization or ED visits within 30 days of discharge.
“These initiatives improve the lives of community members, including in medically underserved areas, and help address major health disparities,” according to a learning module published by the AMA Journal of Ethics.
Importantly, pharmacists can also work with physicians and other members of the healthcare team to contain costs and meet healthcare goals, meeting the benchmarks of value-based models.
Keep in mind that 55% of pharmacists work in a community-based setting and have optimal access to patients and issues with their care. In realization of this potential, the AMA set up the STEPS Forward initiative with pharmacists due to “their expertise in pharmacotherapy and their accessibility.”
The AMA cited numerous examples of the clinical benefit underlying physician-pharmacist collaboration. For instance, when a pharmacist was included on a clinic team in Minnesota, drug-therapy outcomes shot up by 24%. The AMA also noted that in a year-long study involving Black patients, 56.3% of those who received medication-therapy management services from a pharmacist experienced improvement in their diabetes compared with 22.7% of participants in the control group.
How to collaborate
Team-based care that relies on the compassionate care of various professionals has become increasingly important during the past decade. Pharmacists have taken on prominent roles in these teams by modifying medication regimens, eliciting medication histories, and addressing challenges to adherence.
Physicians can increase cooperation and communication with pharmacists with collaborative practice agreements (CPA). “Patient care services provided by pharmacists can reduce fragmentation of care, lower health care costs, and improve health outcomes,” per a CDC white paper. Infrastructure may need to be changed to accommodate a CPA including the practice model, business model, and patient education.
Via CPAs that boost patient access to coordinated care, the scope of a pharmacist’s practice can be augmented in 48 states and Washington, DC. Physicians can assign pharmacists to the responsibilities of initiating, changing, or stopping drug therapies, as well as ordering and reading tests. A US Public Health Service report to the US Surgeon General offers support for pharmacists to perform such services. Of note, CPAs are different in each state.
“Through their medication and health expertise, pharmacists can provide chronic condition management, comprehensive medication management, and medication reconciliation and assessment; help with medication cost reduction; assist in formulary navigation; and facilitate home medication delivery and visits, among many other services,” according to the AMA.
For a CPA to work, it needs to exhibit the following, according to the CDC:
Trust between physicians and pharmacists with established collaboration/privilege parameters
Competence in providing services and sharing findings
Dependable local connections
Consistent written, execution, review, and renewal processes
Conditions set by different types of specialists to surmount any potential challenges
Permission to practice to the fullest extent possible as specified by the agreement
Bottom line
Pharmacists are an excellent clinical resource and provide unfettered access to general and underserved communities. Incorporating their care into integrated teams has a proven track record to enhance patient care and outcomes. One way to boost interaction with pharmacists and further include them in clinical care is through CPAs.