As the nation’s population ages, our medication regimens grow. Government sources cite that 42 percent of American adults take five or more medications – this is up from 14 percent 20 ago. With this dramatic number of individuals on multiple medications, we need a single source to navigate patients and their care teams through the medication complexities. That source is a pharmacist.
The pharmacist’s role continues to evolve. With technological advances in healthcare; greater patient involvement and empowerment; and a greater overall focus on reducing costs and improving health outcomes, pharmacists are a key cog in the wheel of change.
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The Medication Safety Problem
If adverse drug events (ADEs) were classified as a disease, they would be the third leading cause of death behind cardiovascular disease and cancer according to a report published by the NIH. Last year, there were 173,000 deaths due to ADEs in the United States. These events are not triggered by prescriptions that are taken randomly but are due to medications that are prescribed by providers for therapeutic use. Further, a contributing factor to this ADE crisis is that increasing numbers of Americans are consuming multiple medications simultaneously.
The Pharmacist Solution: Accessibility and Expertise
Today, pharmacists are accessible, trusted medication experts. More than 254,000 pharmacists are licensed in the United States, providing services to assure the rational and safe use of all medications – prescribed, OTC, and recreational. In most instances, a pharmacist is the most accessible healthcare practitioner, as 91% of Americans live within five miles of a community pharmacy. Furthermore, the counsel of a local pharmacist requires no insurance, no appointment, and often no wait time.
What qualifies the pharmacist as the medication expert? Pharmacy is one of the oldest of the health professions concerned with health and well-being, and patient care is at the core of the training received in pharmacy school. Today, pharmacy students complete at least six years of schooling, which is often followed by a one- or two-year residency and/or specialty Board Certification (ambulatory care, cardiology, compounding, critical care, geriatrics, infection disease, nuclear, nutrition support, oncology, pediatrics, pharmacotherapy, psychiatric, and solid organ transplant). Whereas most medical practitioners complete only a few pharmacology classes, Pharmacists spend years studying drugs themselves, pharmacokinetics (what the body does to drugs), pharmacogenomics (how drugs are metabolized), pharmacodynamics (what drugs do to the body), and pharmacotherapeutics (how drugs influence specific diseases).
Community pharmacists are already administering vaccinations and smoking cessation programs, supporting diagnostic testing, offering diabetes and other disease-specific education, and more. Beyond dispensing pills and ensuring medication safety, today’s pharmacists serve as educators, empowering patients to manage their own health and well-being.
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Pharmacy Systems and Technology
Medical advancements and the complexities of the nation’s healthcare system exacerbate the need for a single individual to help navigate patients through their medication journeys. Pharmacists’ extensive training is even more valuable when they have access to complete medication profiles (through EMRs, PDMPs, integrated pharmacy systems, etc.). With comprehensive access, pharmacists are uniquely positioned to ‘quarterback’ patient care, working with various prescribers and specialties to ensure medication safety.
Today’s pharmacy capabilities and technologies allow for multi-dose packaging, robotic systems, texting and voice communications that can greatly enhance patient adherence to their medication regimens. And, with new pharmacy-specific medication decision support tools that perform aggregate multi-drug review, pharmacists can prospectively identify patients who are at risk for ADEs and work with healthcare teams to refine and optimize their medication regimens. Pharmacist efforts increase adherence, optimize medication regimens, and prevent ADEs—ultimately leading to better outcomes, including reduced hospitalizations.
The scope of pharmacy practice has evolved – from pharmacy services to counseling, educating, and advising both patients and interdisciplinary healthcare teams. Pharmacists today are equipped to effect positive medication outcomes for all patients and practitioners. Pharmacists can reduce the occurrence of adverse drug events, improve medication adherence, and lower hospital readmission rates.
Medication safety is a significant risk and a growing problem, fueled by the aging of our population, the increasing number and availability of medications, formulary-based practices, and marketing-driven prescribing. Pharmacists are the only professionals sufficiently educated, experienced and equipped to help mitigate medication-related problems and to assist their medical colleagues with safe, optimal prescribing practices. Pharmacists are the most directly accessible medical professionals for patients who are in need. And, with digital information sharing and technology support, pharmacists are able to expertly quarterback patient care to assure medication safety and prevent ADEs. Clearly, it’s time to enlist the help of a pharmacist!
Dr. Calvin Knowlton is the CEO and Founder of Tabula Rasa HealthCare, a leader in medication safety and the top publicly-traded digital health company (Forbes, November 2018). A former two-term President of the American Pharmacists Association, Dr. Knowlton has won numerous awards for his leadership in pharmacy, business and philanthropy in his career of over 30 years. In 1997, he was named the Most Influential U.S. Pharmacist, and his dedication and ambition earned him the 2003 and 2013 Ernest and Young Entrepreneur of the Year Award in the Greater Philadelphia Region. Today, he is a member of the FDA-recognized National Pharmacogenomics Advisory Group, and was recently named a Fellow of the College of Physicians of Philadelphia.
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