Providing Patient Care at All Levels

Lindsay Davis, PharmD, BCPS, ASH-CHC, TTS and Elizabeth Pogge, PharmD, MPH, BCPS-AQ Cardiology, both professors at t Midwestern University College of Pharmacy — Glendale, Glendale, AZ, discuss pharmacists as patient care providers, and managing patients taking anticoagulation medications. This video was filmed at the 2019 American Society of Health-System Pharmacists (ASHP) Summer Meetings & Exhibition in Boston.

Lindsay Davis, PharmD, BCPS, ASH-CHC, TTS: It’s a great question, to figure out how can pharmacists be involved with the management of patients at the direct patient care level or at the stewardship level, which is a little bit more global at the system level or the policy level. When I think about direct patient care, I think about taking really good care of the patient that’s in front of me, making sure I’m listening really carefully, figuring out what’s going on with them, what their needs are, what their concerns are, and making sure that we choose a regimen that makes sense for them, to keep them safe, and also to get the best outcomes that we’re looking for. When I think about policies, I think about all the different ways that we’ve been involved with policies. That could be creating protocols for a practice to make sure that we’re doing the right thing, doing continuous quality improvement work to find out where our gaps are and how we can make them better. When I think about global policy, things like writing white papers or being involved with research or in evidence-based guidelines to make sure that globally we’re taking care of the population.

Elizabeth Pogge, PharmD, MPH, BCPS-AQ Cardiology: From a patient standpoint, some of the things I also think about with the anticoagulation is we need to make sure that they’re on effective therapy, but also make sure that it’s cost-effective. And oftentimes, with some of these newer agents that can be difficult to get them the right medication at the right dose at the right time at the right cost, to make it useful for them. Because a medicine doesn’t work if they’re not taking it. And from a system level, in the hospitals or in the ambulatory care clinics, I love being involved with providers to make decisions on what is the best medication that we should suggest on a system level to use for our patients. So whether or not it’s developing stuff for formulary management, whether or not it’s developing protocols on how we dose agents from anticoagulation, I know that there’s a lot of nuances within that, that we need to think about from a system level and that a pharmacist can be involved in. This world is changing so quickly with anticoagulation, and we need to stay on top of that.