The 2011 Report to the U.S. Surgeon General "Improving Patient and Health System Outcomes Through Advanced Pharmacy Practice" detailed the challenges facing the U.S. healthcare industry: access to care, patient safety, cost of care and the demand for quality are at the forefront.
These challenges are amplified by the looming “Silver Tsunami” and the shortage of healthcare providers needed to care for the sheer volume of patients who will be needing geriatric care. According to The United States Census Bureau, the population of geriatrics (65 and older) in the U.S. has surpassed 50 million for the first time in history and is projected to exceed 70 million in the next decades. Projections suggest a worsening escalation of the burden on the healthcare ecosystem by the aging “baby boomer” population. Innovative and novel paradigms of care must be implemented in order to decrease these burdens.
A recent study by the Patient-Centered Primary Care Collaborative indicates medications are involved in 80% of all treatment plans and affect almost every aspect of a patient’s life. The study also shows that prescriptions dispensed in the United States are estimated to approach 5 billion by 2021.
The alignment of these challenges presents an opportunity for interdisciplinary teamwork with clinical pharmacists to integrate their special skill set to directly improve care.
Many of the largest gaps in patient self-care are linked to issues pharmacists are experts in: medication adherence and compliance, disease-state management, exercise, nutrition and smoking cessation. Patients with chronic conditions often receive care from several specialists; care can become fragmented. Clinical pharmacists are equipped to coordinate care and analyze the broader clinical picture in the context of drug-drug and drug-disease interactions, supporting optimal health outcomes.
PharmD Live's services are designed and implemented by clinical pharmacists. Clinical pharmacists are trained to make high-level clinical decisions, easing the burden on practices and physicians. As a part of one of the most trusted professions, pharmacists provide informed solutions and focus on holistic health. At PharmD Live, we believe clinical pharmacists' extensive training positions them as best-suited to deliver Chronic Care Management Services, Transitions of Care Services, Medication Therapy Management, Annual Wellness Visits and Patient Education. Here's why:
expertise in disease-state management
Helping patients manage their disease state requires extensive knowledge of the disease, etiology, treatment and medication adherence and compliance. Clinical pharmacists extensive training prepares them for comprehensive patient education and care between PCP visits.
expertise in Medication reconciliation
Medication reconciliation can be a time-consuming, complex element of patient care. Minor transcribing differences can majorly impact patient safety. Clinical pharmacists are technical experts, easing the burden on PCPs and improving health outcomes.
Expertise In medication therapy management (MTM)
Expertise in MTM ensures drug therapy is optimized to improve patient outcomes. Clinical pharmacists are trained to identify and mitigate medication-related risks and to care for patients with complex medical needs in the context of drug-drug interactions and drug-disease interactions.
evaluating Return on investment (roi)
the economic and clinical impact of pharmacist-led care
The Asheville Project evaluated long-term clinical and economic outcomes of treating diabetic patients who received pharmaceutical care services (PCS) in a community pharmacy. Results showed diabetic patients sustained clinically meaningful improvements in A1c concentrations from receiving PCS in a community pharmacy. Third party payers reported a decline in medical costs during each year of follow up.
Higher-risk patients—those with elevated A1c concentrations—were most likely to experience a decline in A1c concentrations following PCS. Patients reported increased adherence to behaviors targeted by the American Diabetes Association, including receiving A1c tests, performing foot exams, using angiotensin converting enzyme inhibitors (ACEIs) and performing self-testing of blood glucose. In conclusion, the research study demonstrated clinical and economic impact of PCS in a community pharmacy.
In a 1997 research study by Bootman JL, Harrison DL et al., the impact of pharmacist-conducted, federally mandated, monthly retrospective drug regimen reviews of nursing facility residents on the cost of drug-related morbidity and mortality was assessed. Intervention by a consultant pharmacist was estimated to reduce spending on drug-related problems by $3.6B.
Jameson J, VanNoord G, et al., in a 1995 research study assessed whether a clinical pharmacist intervention with high-risk patients and their primary care physicians would improve prescribing outcome. Patients who received a pharmacotherapy consultation by a clinical pharmacist. The number of drugs, doses per day, medication cost and patient reports of adverse effects were documented at baseline and six months after intervention. The number of drugs and doses as well as drug costs decreased in the consult group and increased in the control group.