When it comes to senior health care, the role of the pharmacist as a critical member of the care team is somewhat underappreciated. Although pharmacists, throughout the course of most of our lifetimes, has been relegated to the roles of simply filling and dispensing doctors' prescriptions, their role is now morphing into that of a limited care provider.
Some states now offer pharmacists the option of obtaining an Advanced Practice Pharmacy (APP) designation. This allows them to provide some services that have heretofore been the exclusive purvey of primary care providers. Pharmacists are now administering vaccines, performing basic wellness checks and coordinating medication regimens. They're providing tobacco cessation treatments and counseling, prescribing birth control and even proactively ordering lab tests to monitor drug regimen compliance.
Why? There are several reasons. Let's take a look at a few of them.
There's a serious shortage of primary care doctors in the US.
That means that obtaining basic preventative services — like annual flu vaccinations, allergy shots, prescription refills, or blood draws to test for therapeutic levels of a maintenance medication (say, for example, Coumadin) — is becoming a bit more difficult.
Most Americans are encountering longer wait times for appointments with their doctors. Physicians are finding it difficult to keep up with their patients' day-to-day needs, and some are starting to slip through the cracks, but APPs can step in to provide necessary services in the pharmacy, which improves preventative care and (ultimately) outcomes.
Pharmacists are qualified to do so much more than fill prescriptions.
Pharmacists, even those without an APP, are highly-trained healthcare providers. Most have just as much or more training as a first-year resident — 2 or 3 years of undergraduate training, followed by a 4-year pharmacy program. And pharmacy programs aren't for the faint of heart. Some are more competitive, admissions-wise, than medical schools. Many students go on to complete advanced study programs after completing their PharmD coursework. A lot of graduates now seek placement in clinical pharmacy residency programs.
What does that mean? It means that relegating pharmacists to filling prescriptions represented a tremendous waste of clinical potential. And now that the healthcare provider market is facing tremendous strain, pharmacists are being called upon to shore up the works.
Pharmacists can help navigate drug coverage issues.
Another emerging function of the pharmacist is that of go-between for patients and their prescription coverage providers. No one appreciates being surprised with an unexpectedly high copay or denial of coverage when he or she arrives to pick up a prescription.
Most pharmacies, though, seek precertification for coverage on prescriptions. New, automated medical record systems allow doctors to electronically send prescriptions directly to a preferred pharmacy, which can immediately send that prescription on to an insurance company to check for coverage.
When problems arise, the pharmacist can call the patient and prescribing doctor and let them know before the individual even sets foot in the pharmacy door. A pharmacist can also suggest to the prescribing doctor an acceptable alternative medication that meets therapeutic and budgetary needs.
Pharmacists may be in a better position than doctors to prevent drug mishaps.
That's because they often have electronic access to an individual's complete medication list and drug sensitivity history, which means that they aren't as reliant upon an older adult or family member to provide a complete and thorough history — something that many primary care providers find it difficult to obtain.
This is especially true if (as most people do) an older adult fills all his or her prescriptions at the same grocery, chain, or neighborhood pharmacy, regardless of which doctor has prescribed them. In a sense, the pharmacist functions as the catch-all safety net.
Many elderly adults see a variety of different specialists to manage their chronic conditions, but they forget (or fail) to inform their primary care doctors of changes and additions made by those specialists to their medication regimens.
The pharmacist, however, sees those changes as they come in. He or she can contact a prescribing doctor or primary care physician to verify dosages — or to seek an alternative prescription when a drug presents an unacceptable risk.
He or she can also immediately inform the individual — or, in the case of a senior who cannot care for him or herself, a daily care provider or power of attorney — if an unsafe medication situation arises. That allows a senior or a senior's family to take action immediately and avoid the danger.
Senior health care is undergoing significant changes.
The pharmacist has a critical role to play in the emerging care model. Get to know yours and develop that care provision relationship. It could save your life — or the life of an elderly loved one.
