Specialty Pharmacists Are Essential Patient Advocates

In addition to providing necessary education for patients receiving treatments for complex diseases, specialty pharmacists can work as advocates within the difficult to access health care system, said presenter Georgeanne Vartorella, MD, founder and president of Patient Advocacy MD, in the keynote address at the American Society of Health-System Pharmacists (ASHP) Specialty Pharmacist Conference.

Helping her parents navigate through long, terminal illnesses opened her eyes to the importance of patient advocates, Vartorella said. New advancements in tools and technology have empowered patients to engage as informed participants, but Vartorella said major obstacles still exist within the health care system.

The COVID-19 pandemic shed light on these obstacles, which include barriers to delivery, access, and payment. Vartorella said that all stakeholders—physicians, pharmacists, payers, and others—are siloed and do not share information. This lack of communication has a ripple effect, when patients cannot communicate effectively with their health care team and certainly cannot communicate with payers.

“The walls to get into the health care system, access quality care, and get it paid for are rapidly becoming harder and harder to scale, not only for patients, their families, and caregivers, but for those of us that provide services,” Vartorella said in the presentation.

This inability to communicate can lead to burnout among providers, she said, leaving professionals feeling frustrated, disengaged, and unempowered. Historically, she said health care professionals have been told to “buck up, show up, and take it,” but unintended consequences of the new medical environment are leaving professionals disillusioned and alienated. She also noted a profound lack of alignment between caregivers’ values and the health care delivery system.

“This dissonance spills over and infects patients’ families and the support system with the same disease of discontent, alienation, and misalignment,” Vartorella said.

Improving communication and helping bridge gaps in the health care system is the major role of advocates. Increasingly, Vartorella said health care systems, employers, and insurers are becoming advocates, although many of these individuals do not have the knowledge, expertise, or training necessary to navigate the complex system.

“Certainly, we need everyone to be advocates—beginning with patients, families, and caregivers, as well as the [professional] advocates I’ve mentioned,” Vartorella said.

She added that real advocacy requires education and leadership, or it could easily end up siloed like other stakeholders in the industry. Although they often go between a myriad of professionals, including physicians, payers, and patients, Vartorella added that advocates must know when to step back and consult experts. For example, she said knowing when to include a lawyer or insurance expert is vital to ensuring that patients receive the best care as efficiently as possible.

Specialty pharmacists are a group of experts who Vartorella said she frequently works with. In addition to helping guide patients through necessary treatments, specialty pharmacists have the expertise and respect to advocate effectively within the medical community, Vartorella said.

Advocating for patients at the end of life is one such time when pharmacists can play a key role. By understanding the various potential outcomes of complex diseases and listening carefully to patients and their families, pharmacists can be essential in preparing patients for end-of-life care.

“As an advocate, what I see over and over again when faced with a serious or terminal illness, is that patients are typically receiving good care with best, state-of-the art medications that very well might improve quality of life, extend that life, or even cure the illness,” Vartorella said.

What these patients lack, however, is a roadmap of the various potential outcomes and how to prepare for them. Managing their expectations and listening to their desires is one of the most important roles for health teams and advocates.

“Time after time, I see patients and their families unnecessarily and sadly scrambling at the end, surprised at the inevitable,” Vartorella said. “They’re not prepared, and they’re even shocked that their loved one is dying, and the patient is unable to express how they want to live.”

By communicating, facilitating, and educating both patients and other providers, specialty pharmacists and patient advocates can help patients live out their final days with peace and dignity, Vartorella said. She concluded that pharmacy specialists are essential in these situations, with the gravitas, influence, expertise, and training to change the health care system, build trust, lower costs, and optimize outcomes according to patients’ values, needs, and goals.

REFERENCE

Vartorella G. Keynote: Drumbeat for Our Patients’ Best Outcomes. Presented at: American Society of Health-System Pharmacists (ASHP) Specialty Pharmacist Conference. July 14, 2021. Accessed July 14, 2021. https://www.eventscribe.net/2021/SpecialtyPharmacy/myplan.asp?afp=QlJJQU46NDk1MzUyMDg6bVF5azVqU1o