Brown Bag Consults: Raising the Bar

Remember when participating in a community brown bag consult was mandatory in pharmacy school? Students would arrived prepared with drug references in hand, ready to go through all of the medications that patients brought with them.

Back then, the main focus of a brown bag consult was to ensure that the patient knew the name and correct dose of the medication, what it was for, and the importance of adherence. But today, pharmacists can take community brown bag consults to another level.

Focusing more on the patient than the drugs can potentially make a bigger impact on outcomes and quality of life. The patient interview process can be key in recognizing problems that have not be corrected by current drug therapy, and it can even identify new problems that have not been addressed by a physician.

Here are a few things that can be included in today’s brown bag consults that might not have been addressed in the past by a pharmacist:

Lifestyle modification encouragement

Even though pharmacists are in a profession that dispenses medications to improve specific disease states, it would be beneficial to support and encourage lifestyle modifications so that patients can eventually not require many drugs at all.

Emphasizing nutritional modifications, exercise, and stress reduction would make a huge impact on patients with hypertension, obesity, and/or depression. Focusing on the root of diseases during counseling could shed new light on the problems.

Lifestyle modification supports getting the body back to its normal rhythm and balance, reduces the need for high doses of medication

—or

medications at all

—

and improves the quality of life for the patient and his or her entire family unit.

Proper medication storage and handling

Many medications have specific storage requirements that determine their effectiveness. One example is the anticoagulant dabigatran (Pradaxa), which needs to be maintained in the manufacturer’s bottle to prevent loss of potency.

Asking specific questions about patients' lifestyles, whether they have a caregiver, and whether they use a pill box for most of their medications can prevent these types of errors.

Resources for low-cost medications

Access to care and medications still remains a big issue. With many retail pharmacies now offering $4 generics drugs, discounts, support for homeless patients, and clinics for veterans, pharmacists can play a significant role in steering patients in the right direction.

Cultivating relationships with other health care professionals and working with the multidisciplinary care team helps pharmacists gain knowledge of resources for patients.

Hypertension, diabetes, and body mass index testing

Setting up stations at a brown bag consult where pharmacists can evaluate and monitor a patient’s blood pressure, blood glucose, and weight can help patients gain more control of their health and become better historians and participants in determining future drug therapy.

Given that physicians have less time to assess patients thoroughly during office visits, keeping track of these vitals and being more aware of changes in measurements can assist physicians in making better treatment decisions.

Proper dosing and medication adherence

Proper medication compliance is of the utmost importance for patients. There are no short cuts when it comes to proper drug therapy.

When counseling patients, it is imperative for pharmacists to ask the right open-ended questions, such as “How do you take your medication?” “How often and how many pills are needed for your dose?” and “When was the last time you had your prescription filled?”

Face-to-face interaction has always been a means to success for the patient-pharmacist relationship, as well as improvement in compliance and drug therapy.