Recognition Still Needed for Collaborative Pharmacy Services

A little more than 20 years ago, I participated in my pharmacy school’s summer grant program that focused on incorporating pharmacists into the interdisciplinary health care team.

The pharmacy field needed to move from strictly dispensing services to providing pharmaceutical care. This has always been the ultimate goal for a pharmacy career.

The American Pharmacists Association describes pharmaceutical care as a patient-centered, outcomes-oriented pharmacy practice that requires the pharmacist to work in concert with a patient and his or her other health care providers to promote health, prevent disease, and assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective.

Fast forward 20 years later, when a consortium was held in Washington, DC, to help develop consensus recommendations that provide principles and strategies for effectively implementing health care system changes, including an optimized role for pharmacists to engage in team-based, patient-centered care. This group was comprised stakeholders representing 12 states and 10 pharmacy practice settings, and the participants came from pharmacy, medicine, and nursing.

The consortium devised 7 recommendations for advancing pharmacists’ patient care services and collaborative practice agreements. They are:

• Use of consistent terminology.
• Provider control over collaborative practice details.
• Infrastructure that embeds pharmacists’ patient care services and collaborative practice agreements into care.
• Use of electronic health records and technology in patient care services.
• Relationships among the health care team that are strong, trusting, and mutually beneficial.
• Incentive alignments based on meaningful process and outcome measures.
• Redesign of health professionals’ practice acts, education curriculums, and operational policies.

Collaborative pharmacy services are basically the same as pharmaceutical care but with incentives based on meaningful processes and outcome measures. Pharmacists have provided meaningful processes and outcome measures for as long as the profession has been in existence, so why is formal recognition taking so long? And why aren’t pharmacists taking the initiative, individually or through pharmacy associations, to take the reins and move the profession forward?

In completing general and specialty residencies and board certifications, pharmacists are educated, skilled, and experienced to participate in collaborative pharmacy services, and we do on a daily basis.

What needs to happen next is pharmacists taking the initiative to seek out practice agreements with physicians. There is federal government interest in pharmacist-provided services from the US Centers for Medicare and Medicaid Services, US Centers for Disease Control and Prevention, and Surgeon General.

Pharmacists have established integral relationships with physicians in their practices that could potentially springboard that relationship to a more formal collaborative pharmacy service agreement. That is, if pharmacists would market services as outcomes-based patient care.

How can we do this? Participate and endorse our state pharmacy associations to work on our behalf for provider status changes and work individually to raise the standard of pharmacy practice among all other health care practitioners by offering to monitor and assess more patients of a particular disease state. Let’s be each other’s cheerleaders for going over and beyond our daily responsibilities and praise additional training and education among our co-workers.

As the old saying goes, “a closed mouth doesn’t get fed.”