Community pharmacy evolves to provide direct patient care

Collaboration with academic centers extends clinical services to help support health care goals.

The community pharmacy is often the first place patients, residents and even future students of the profession meet a pharmacist.

Pharmacists play a key role in communities across the country. More than 62,000 community pharmacies are the gateway to the profession.1 Almost 9 in 10 Americans live within 5 miles of a community pharmacy, making these stores arguably the most readily available access points for health care in the United States.2

Most American communities have pharmacies that provide access to vaccines and medications, which are essential public health services. However, the business model supporting the distribution of pharmaceuticals is changing rapidly while reimbursement for pharmaceuticals is declining.

This affects the functioning of pharmacies and pushes them to broaden their scope from a commercial and public health point of view. As pharmacists seek new ways to maximize their impact and their roles
in the provision of health care services to the public, the need to expand clinical services has become evident.

New pharmacists facilitate change

With new graduates joining the ranks of the profession each year, academics and store executives have sought ways to transform the traditional model of product-focused community pharmacy into one of patient-centered care. As community pharmacies experience dramatic changes in the way pharmaceuticals are reimbursed, there is a growing movement towards pharmacies with connected and coordinated care that delivers value to the healthcare system and to patients. The ability to harness the study-oriented clinical skills with the business skills of a community pharmacy grows and increases patient care while diversifying business channels.

Organization of changes

The Academia-CPESN Transformation (ACT) Pharmacy Collaborative is designed by store leaders, owners and faculty from various schools to catapult the transformation of community pharmacy practice nationwide. ACT is a fully engaged forum between an established and clinically integrated network of community stores and schools of pharmacy who have agreed to collaborate to provide better clinical services within the framework of community pharmacy. The collaboration offers academics the opportunity to share their experiences with existing community pharmacy partnerships and understand the business side of pharmacy efforts. Along the way, each partner benefits from sharing ideas, encountering new challenges and solving problems together.

ACT is supported by a grant from the Community Pharmacy Foundation. Its design is a direct result of the contributions provided by the leaders of the Enhanced Community Pharmacy Service Network (or CPESN) and more than 111 faculty members from 66 pharmacy schools in 33 states. These innovators work with local pharmaceutical networks to accelerate practice transformation and help ensure university programs support graduate knowledge and skills in evolving community practice. Academia can leverage its existing expertise by amplifying ongoing efforts in innovative community pharmacies that pave the way for widespread practice transformation.

Improved pharmacy services

Enhanced Community Pharmacy Services are health-related and drug-related services that help patients achieve their health care goals. These are pharmacy services that go beyond the distribution of pharmaceutical products. Health care payers are interested in mechanisms to improve quality and value, while prescribers are incentivized to meet patient health goals. Eighty percent of chronic disease management is related to drug therapy. The proper use of medications is an essential step in achieving health outcomes for patients living with chronic illnesses. Community pharmacy teams are well positioned to help patients manage their health care goals with these enhanced services.

Once a community pharmacy commits to being part of the ACT collaboration, they can expect to be able to offer many other clinical services. The following areas of interest are examples of these enhanced service offerings:

  • Alignment of chronic drug refills to be completed on the same day as other pharmacy visits to review progress towards health care goals
  • Documentation in a pharmacist’s standardized eCare plan with the possibility of sending the plan electronically to the prescriber’s electronic health record (see ecareplaninitiative.com)
  • In-person access with a pharmacist during scheduled and walk-in appointments to assess the patient’s medications
  • Medication Reconciliation to assess and compare prescriptions for medications to what’s taken home to ensure patients are receiving the most appropriate, effective and safe regimen to meet health goals
  • Screen patients to ensure they are aware of recommended vaccinations related to their care
  • Systematic assessments of patient medications and related health issues to identify medication issues to create a patient plan to resolve them in collaboration with other members of the healthcare team

Other areas where community pharmacists can improve patient care include adhesion packaging, administration of long-acting injectables, distribution and monitoring of clozapine, health education. ” diabetes self-management, assessment and support of durable medical equipment, hearing aids, home visits, naloxone administration education, smoking cessation counseling and triage of ailments and conditions common and minor.

How to join

For more information and details on how to get involved with ACT, contact Melissa Somma McGivney, director of ACT Pharmacy Collaborative and Professor and Associate Dean for Community Partnerships at the University of Pittsburgh in Pennsylvania at mmcgivney @ pitt. edu.

Ned Milenkovich, PharmD, JD, is the chair of the healthcare law practice at Much PC in Chicago, Illinois.

THE REFERENCES

  1. Ponushis A, Gandhi N. The future of community pharmacy: direct patient care. American Association of Faculties of Pharmacy. Accessed April 20, 2021. https://www.aacp.org/article/future-community-pharmacy-direct-patient-care
  2. CDC. Get to know your pharmacist. Updated January 4, 2021. Accessed April 23, 2021. https://www.cdc.gov/heartdisease/pharmacist.htm#:~:text=An%20important%20member%20of%20your,talk%20with%20about % 20your% 20health


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