Good Medicine: The Doctor and Pharmacist Team | Consumer Health Information Corporation

Good Medicine: The Doctor and Pharmacist Team

David Douglas Hall, Doctor of Pharmacy Candidate - 2001
University of Missouri - Kansas City
School of Pharmacy

Today's medicines give us cures and treatments that seemed impossible only a few years ago. When used correctly, these medicines keep us healthier and help us lead more active lives. When it comes to treating you, Missouri doctors and pharmacists are finding new and better ways to work together so that you can get the most benefit from your medicines.

Doctors and pharmacists in 30 other states have realized that when they "team up" and use special treatment plans, they can offer even better care to their patients.1 The Missouri Pharmacy Practice Act, which regulates the way that pharmacists are allowed to practice, is now being revised to support a better doctor and pharmacist team approach that allows pharmacists to help doctors monitor how patients are responding to their medicine between doctor visits.2

In an Illinois study of patients with high blood pressure patients, adding the community pharmacist to the treatment team helped keep the patients blood pressure under better control and help prevent more serious health problems.3

At each refill visit, how will my pharmacist work with my doctor?

Under the new Missouri Pharmacy Practice Act, your doctor and pharmacist would develop a specific plan to allow the pharmacist to monitor your health between doctor visits.4 Each time you refilled your prescription, your pharmacist would take a few extra minutes to meet with you.

The pharmacist might perform a simple test to make sure your medicine is working for you (such as checking your blood pressure) and ask you questions about how you are feeling and if you are having any trouble remembering to take your medicines.

The pharmacist would ask about problems you think might be due to your medicine, and suggest ways to help reduce those side effects so you can continue to take your medicines.5

In some cases, the pharmacist would adjust your dose to improve your treatment to reach the goals you and your doctor set. Any changes in your dose would follow strict guidelines your doctor has given to your pharmacist.

Doctor and pharmacist agreements would outline how the pharmacist and doctor share information about your medicine and lab tests, so that they are both working with the same information. In most cases, the pharmacist would write a detailed report for your doctor to review and place in your chart.

The pharmacist will also help you check for changes in your health. For example, if the pharmacist finds that you have serious problems with your blood pressure or blood sugar or that you are developing early symptoms of a serious side effect, the pharmacist will refer you immediately to your doctor. This will help prevent any potentially serious health issues early so they can be treated immediately and not get worse. This could even save your life!

How can this make a difference in my health?

In March 2000, the Journal of the American Medical Association (JAMA) published a study showing that pharmacists and doctors working together reduced side effects and mistakes using medicines.6 Other studies show that pharmacists can reduce the number of needed doctor and hospital visits for many patients.7 Pharmacists can help keep you healthier and teach you how to manage minor side effects so that you do not have to see your doctor or take as much time off from work. This leads to lowering your healthcare costs.5

Will all pharmacists provide this service?

Not all pharmacists will choose to participate in these agreements. Your doctor and the State Board of Pharmacy will decide which pharmacists are qualified to make these agreements and monitor your health.4

Will health insurance pay for pharmacist services?

This is a new approach to healthcare for patients. Many insurance companies are looking at the studies and recognizing that pharmacists can improve healthcare and reduce healthcare cost. As you, your doctor, and your pharmacist show insurance companies these benefits, they may start to cover your pharmacist visits.

A Texas study showed that in an anticoagulation (blood thinning) clinic staffed by pharmacists, the pharmacists saved patients an average $1600 a year and the patients seeing a pharmacist between doctor visits had fewer deaths due to blood clots.8

How are pharmacists working to make these agreements possible?

Pharmacists and doctors in over 30 states already have these agreements and are seeing the benefits in many areas of healthcare. So the proof is there for the "Show Me" state.1

The Missouri Pharmacy Association is seeking approval from the Missouri Legislature to change the Missouri Pharmacy Practice Act to allow these doctor and pharmacist agreements. Once this is approved, pharmacists who are able to meet strict criteria would be able to make agreements with doctors to help monitor and adjust your medications between doctor visits.4

This would not only help your pharmacist provide better feedback to your doctor between your doctor visits, but it would also give you more information and time to ask your pharmacist questions about your medicines. It is a win-win for doctors, pharmacists, and the patient.

What can I, the consumer, do to voice my opinion?

Call, write, or email your local state senator and representative. Their names can be found at the legislature's web site at www.moga.state.mo.us. Next, let them know that you want them to "support the Missouri Pharmacy Association and allow your Missouri pharmacist and doctors to team up for your better health." Take a few minutes today to help Missouri pharmacists better serve you and your doctor.

References:
1. States with Collaborative Drug Therapy Management Agreements. APhA's Legislative Action Center. http://congress.nw.dc.us/cgi-bin/alertpr.pl?dir=aphanet&alert=150. Accessed 03/01/01.

2. Missouri Revised Statute Chapter 338.010 Pharmacist and Pharmacies. http://www.moga.state.mo.us/statutes/c300-399/3380010.htm. Accessed 03/12/01.

3. Carter BL, Barnette DJ, Chrischilles E, Mazzotti G, Asali ZJ. Evaluation of Hypertensive Patients after Care Provided by Community Pharmacist in a Rural Setting. Pharmacotherapy 1997;17(6):1274-1285.

4. HOUSE BILL 462 Missouri Pharmacy Practice Act. http://www.house.state.mo.us/bills01/biltx01/intro01/HB0462I.htm. Accessed 03/12/01.

5. APHA Fact Sheet. The Pharmacy Profession: Transitioning from Prescription Provider to Health Care Manager. http://www.aphanet.org/relations/Fact_Sheet.htm. Accessed 03/01/01.

6. Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, Bates DW. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA 1999 Jul 21;282(3):267-70.

7. Carter BL. Clinical Pharmacy in Disease-Specific Clinics. Pharmacotherapy 2000;20(10 pt 2):273S-277S.

8. Chiquette E, Amato MG, Bussey HI. Comparisons of an Anticoagulation Clinic with Usual Medical Care: Anticoagulation Control, Patient Outcomes, and Health Care Cost.