Improving Healthcare for Chronic Disease: A New Pharmacy Model for a New Day
Last month, the American Pharmacists Association met with senior staff from the Center for Disease Control’s (CDC) Division for Heart Disease and Stroke Prevention to discuss the role that pharmacists play in reducing the rate of stroke and heart disease in patients, and further, to better monitor the outcome of these patients and improvements in these outcomes. This meeting is the latest in a series of efforts the CDC has initiated in exploring a new pharmacy model to use our healthcare resources more efficiently. Coming on the heels of state efforts to expand the role of pharmacists in patient care, we should applaud these efforts, and further examine how to best utilize our skills in the medical and healthcare arenas.
Why Is the CDC Interested in a New Pharmacy Model?
The CDC has decreed that U.S. healthcare is in a time of transformation.1 Not only has the Affordable Care Act completely changed the landscape of how people use healthcare in terms of frequency, reason, and provider, but the national outlook on the success of the U.S. healthcare system is also changing, particularly in terms of:
- Access to care
- Quality of care
- Healthcare costs
- Medication adherence
- Medication safety
Pharmacists are already an essential part of each of these categories, but so far it hasn’t been enough. Current estimates of physician supply and demand indicate that 52,000 to 91,000 new physicians will be needed by 2020, with a demand of more than 130,000 new physicians needed by 2025. The current healthcare model simply does not work.
Other stakeholders have also seen this trend and are responding with increases in home-based care, expanded team-based care, family and extended support engagement, and better preventive care. These are important initiatives. Chronic disease is the leading cause of death in Americans, with no less than one-half of patients suffering from at least one chronic condition. This means the burden of healthcare, typically in the form of medications, is a question of management. In fact, just over 90% of patients manage their chronic diseases, such as heart disease, through prescriptions.
Unlike physicians, pharmacists have access to patients in urban, suburban and rural areas, with approximately 275 million visits to a pharmacy each week. It makes sense why the CDC is looking to a new pharmacy model for patient healthcare.2
How Do We Fit Into New Pharmacy Model?
Pharmacists sometimes have to work a little to find out where and how they bit in best within a patient’s healthcare team. Oftentimes, the pharmacist is brought into the team simply to be in the loop or to educate other team members on the important peculiarities of the patient (his allergies, competing treatments, and significant side effects of multiple medications). It behooves us to consider how we best fit into a new pharmacy model for better healthcare. The case of stroke and heart disease management is a great example.
The CDC has implemented a five-year project in every state and the District of Columbia that points to new pharmacy models and roles.3 Specifically, this model is based on the fact that pharmacists are adept at:
- Medication management, either alone or as part of a disease management team
- Medication reconciliation, especially during transitions in care
- Preventive care services
- Education and behavioral counseling
- Integration into collaborative care models
How Does This Fit Into Stroke and Heart Disease?
A study conducted on congestive heart failure was used as part of the case the CDC made for a new pharmacy model for patient healthcare us. Patients in a Claremore, OK, hospital were given extra counseling by pharmacists in the hospital and in post-discharge care. The study results showed:
- A reduction in patient readmission
- A reduction in ER usage
- Increased usage of prescribed heart medications
- A significant reduction in healthcare costs
Clearly using a new pharmacy model was successful in this case. The obvious question that follows is that is this model the right one for every pharmacy? The easy answer is ‘no.’ The better answer is that ‘it depends.’
The best model for any pharmacy is the one that works with the resources available. Maybe in your community, urgent and ER access is unencumbered so those physicians are easily at hand. Or maybe you work in a community that has long pharmacy lines and delayed physician appointments. If so, talk to your patients. Look at what they need and what care they are getting. It could very well be that you can help them with the skills you have, and with state and federal support behind you.4 Advocating for your patient may start with advocating for yourself.
The national burden of stroke and heart disease, as well as other chronic conditions, continues to increase each year. Luckily, there are various medications and care regimes that can manage these conditions and allow patients to live an otherwise healthy life. Pharmaceutica North America is committed to providing you with safe and high-quality compounding materials that you can feel sure in dispensing. Let us help you give your patients the care and confidence they deserve. Contact us today for more information.
- “How Pharmacists Can Improve Our Nation’s Health, October 21, 2014, http://www.cdc.gov/cdcgrandrounds/pdf/gr-pharmacists-10-21-2014.pdf ↩
- “A ‘heart to heart’ with CDC,” September 3, 2015, http://www.pharmacist.com/CEOBlog/heart-heart-cdc ↩
- “CDC program makes case that pharmacists improve public health,” November 1, 2014, http://www.pharmacist.com/cdc-program-makes-case-pharmacists-improve-public-health ↩
- “Collaborative Practice Agreements and Pharmacists’ Patient Care Services, October 2013, http://www.cdc.gov/dhdsp/pubs/docs/Translational_Tools_Pharmacists.pdf ↩