The number of Americans battling diabetes, hypertension, high cholesterol, and other chronic diseases has been steadily increasing. Meanwhile, the amount of primary care providers (PCPs) handling these diseases is decreasing.
As the gap between patient needs and available resources continues to widen, John Gums, Associate Dean for Clinical Affairs and Professor of Pharmacy and Medicine at the University of Florida, offered a solution in a recent article. He suggests working through pharmacists to fill the rising needs of those with chronic diseases.
Pharmacy—More than Counting Pills
Most people don’t realize how much pharmacists are trained to do, considering the day-to-day roles they see them in. Those admitted into pharmacy school have developed a sound understanding of chemistry, biology, and mathematics; passed the standardized Pharmacy College Admissions Test (or PCAT); and demonstrated high levels of academic excellence in their undergraduate career.
Those who make it through the next four years of rigorous learning, training, and internships have to pass a licensing exam, and many go on to complete board certifications in specialty areas as well.
Because of this, Gums assures us that the local pharmacist is not only capable of helping with drug therapy management, but also with preventive care, patient counseling, and overall health and wellness. He also asserts that they have the training needed to help manage many of the chronic diseases that are becoming more and more common today.
The Perks of Using Pharmacists
In addition to their wealth of knowledge, pharmacists tend to be more accessible than primary care providers. While most PCPs are only open during regular business hours, generally pharmacies open earlier and close later. In addition, appointments are not typically necessary to meet with a pharmacist, making it much easier for a patient to get the care right when they need it.
With the number of prescriptions constantly rising, the need for proper patient care is increasing and urgent. The Centers for Disease Control and Prevention estimates that 29% of adults take five or more medications.
Collaborative care models—or partnerships between PCPs and pharmacists, could be the solution to ensuring that no patient is left behind. Gums explains that “collaborative care models have been shown to improve outcomes in patients with hypertension, diabetes, clotting disorders and high cholesterol.”
Thus, the shortage of care for those facing many chronic diseases can be met, and primary care providers will have the time to treat the patients that really need them most.
What’s Holding Us Back?
If a pharmacy and PCP partnership is really such a good idea, why aren’t we already implementing it? First, there are very few states that actually allow pharmacists to play an active role in patient health care. Statutes and regulations limit a pharmacist’s authorization to complete medical histories or order laboratory tests. However, these regulations are not the only barrier preventing pharmacists from becoming more involved in patient care.
Gums explains that the pharmacists are paid based on the number of prescriptions they fill. As such, even in the states where there are opportunities for the pharmacists to participate in patient care, there is little incentive and no monetary reward for taking the time to do so.
Still, change is slowly in process. Both the House and the Senate currently have bills proposed to develop pharmacist-specific codes for insurance reimbursements. And, on the state level, some states are beginning to take action to increase the scope of practice—including integration of Advanced Pharmacist Practice (APP) recognition that would allow pharmacists to participate in evaluation, management, and treatment of diseases and health conditions in collaboration with primary care providers.
Gums concludes “once laws catch up to what pharmacists are really trained to do, it will be the patients who benefit the most.”