Expert: Transforming Pharmacy Practice and Elevating the Role of Pharmacists in Puerto Rico

To celebrate American Pharmacists Month, Pharmacy Times® interviewed Ilianette Miranda, RPh, owner of Sagrado Corazon Pharmacies in Sabana Grande, Puerto Rico. Miranda is a pharmacist with 25 years of experience in Puerto Rico, advocating for the recognition of pharmacists as health care providers. Throughout her career, she has emphasized the crucial role pharmacists play in improving patient outcomes and reducing health care costs. Miranda was nominated for the 2024 Community Leadership Award, sponsored by Cardinal Health, emphasizing her commitment to advocate for the role of the pharmacy profession.

Pharmacy Times

Can you start by introducing yourself?

Ilianette Miranda

I'm Ilianette Miranda. I'm a pharmacist in Puerto Rico for 25 years. I was part of several legal pharmacy organizations in Puerto Rico, serving as an advocate of my profession, looking for recognition of pharmacists as a health care provider and finding the opportunity to integrate the pharmacy in our health care system. Also, I'm working with other peers to provide assistance of the community pharmacy in the island. I have 2 pharmacies in a little town in the west coast of my island.

Pharmacy Times

How did you get started with pharmacy?

Ilianette Miranda

I started as a pharmacy staff in community pharmacy, then as a pharmacist in charge, and then opened my first pharmacy 17 years ago. My second pharmacy opened in 2013. My practice is different, and so I innovate. One of my pharmacies is an integrated ballistic concept of functional medicine and traditional medicine with compounding supplements, homeopathy and vaccines. I am a collaborator of the University of Puerto Rico, a lecturer of the homeopathy program of the University. The other pharmacy is a traditional pharmacy that offers clinical services, technology, location and also provide vaccinations. Also, we work with collaborative practices with physicians and Medicare Advantage Plans promoting adulterants vaccines and services of transitions of care.

Pharmacy Times

How have you seen the profession change over your career?

Ilianette Miranda

I have seen a lot of change in 25 years as a pharmacist. Some examples here in Puerto Rico include that the pharmacist can vaccinate. The pharmacies have more opportunities, like managed care. In Puerto Rico, the pharmacists need to complete a doctoral degree — in the 1990s the pharmacist only needed to have a bachelor’s degree. The pharmacists can administer some medications in the pharmacy, like injections, with prescription, but the pharmacists can do this job. The profession also is looking as an integrate part of the health care system with these changes, and that's awesome. You can also see collaborative agreements with pharmacies and physicians, pharmacies and health care plans, and pharmacies and hospitals. So, there is a change in the setting of the provision of care, but there is a lot of work to do.

Pharmacy Times

What is the most rewarding part of pharmacy for you?

Ilianette Miranda

The most rewarding part of pharmacy is being part of the positive results in the health of my patients. The fact that they return satisfied is the result of duty fulfilled as a pharmacist.

Pharmacy Times

What is the value of the pharmacists to you personally and to the overall health care system?

Ilianette Miranda

The value of the pharmacist, who plays a crucial role in the health care systems is to ensure optimal patient care, medication safety and improve health outcomes — that for me is the value of the practice. The contribution of the pharmacist managing medications for chronic diseases now is vital in the health care system. You can reduce health care costs now that the theme of cost is so important in the pharmacy and for Medicare, the pharmacist plays a crucial role here.

Pharmacy Times

With the role of the pharmacists growing, what is the importance of the pharmacists for the patients and the community?

Ilianette Miranda

Pharmacists are the most accessible primary health care professionals who support health and well-being, and the pharmacists are trust places in our local communities to go for health care— that's the first one. With these 2 elements in our favor, the role of the pharmacist intensifies in our communities, and the opportunity of the pharmacist to continue integrating into the health care system is present. So, the role of the pharmacist remains important in communities.

Pharmacy Times

How are you celebrating this American Pharmacists Month this year?

Ilianette Miranda

Oh yes. In Puerto Rico, Pharmacist Month is in in April. But in the United States, we celebrate in October and that's awesome. The valuable role of the pharmacist should be celebrated every day,but this October, personally, I will be celebrating with the Colegio de Farmacèuticos de Puerto Rico. It is an honor for me to receive this distinction and I'm going to celebrate with my patients and my pharmacy staff. Every day we can do a lot of work for the communities, and this month, we are going to increase.

Pharmacy Times

Is there anything you would like to add?

Ilianette Miranda

In Puerto Rico, the pharmacists are not recognized as health care providers, and there is a lot of work to do. I have a mission as a pharmacist to advocate for my patients and ensuring that they receive the best possible care. If we are going to be recognized as a health care provider in Puerto Rico, it is going to be a positive result that they're going to be a redundance of positive outcomes for my patients. And thanks a lot for this interview. I'm so glad to be here.