The Pharmacist's Expanded Role

What an exciting time to be a pharmacist! Our role is expanding, more pharmacists are participating, and new opportunities are becoming available. This has been documented by results from the recently released Pharmacy Workforce Center’s 2014 National Pharmacist Workforce Survey that indicate pharmacists are performing more patient care activities in a variety of health care settings and spending less time in the traditional dispensing role. According to this report, 60% of pharmacists provided medication therapy management and 53% performed immunizations versus 13% and 15%, respectively, in 2004. Clearly, we are seeing an expanded pharmacist role.

That others outside of pharmacy recognize the importance of pharmacists and their expanded role is demonstrated by the recent National Governors Association paper, “The Expanding Role of Pharmacists in a Transformed Health Care System.” The paper states: “Pharmacists practice in a variety of health care settings. Although they are most often associated with dispensing medications in retail pharmacies, their role is evolving to include providing direct care to patients as members of integrated health care provider teams.” The paper then identifies how pharmacists provide expanded services, identifies key challenges and barriers, and suggests rules and regulations that could help secure opportunities for pharmacists to perform an expanded role.

Our message that we can do more to benefit patients is being heard and addressed. That is why I started this commentary with “What an exciting time to be a pharmacist!” As we begin to promote an expanded role, I think now is a good time to reflect on the themes that helped support the expanded role for the pharmacist.

Although external forces played a role, I think the major thrust has come from the pharmacists themselves as they perceived societal needs that could be best addressed by the pharmacy profession. I identify 4 themes that influenced pharmacists to want to expand their role:

• Pharmacists must be in charge of drug product acquisition, distribution, and control. Costeffective drug therapy requires that the right drug product is available to the patient. Pharmacists fill this role best.
• Pharmacists must ensure patient safety in the drug use process. When used appropriately, drugs achieve positive results; when used inappropriately, they can be very harmful. Pharmacists realized they had a responsibility to their patients and other team members to guarantee the safe use and distribution of medications.
• Pharmacists must promote rational drug therapy. As pharmacists ensured that drugs were used safely, as the drug expert on the team, they realized they needed to promote rational and cost-effective drug therapy. Thus, they became involved in medication therapy management to make sure drugs were used as intended.
• Pharmacists must accept their mission to foster optimal patient outcomes from medication use. Pharmacists have more contact with patients than the other health care team members. They are uniquely positioned to assess whether desired drug therapy outcomes are being achieved.

Now that most pharmacists recognize, accept, and have become engaged in delivering an expanded role, we must make sure that other team members and legislators understand, accept, and support this expanded role. Pharmacists are emerging as essential members of the health team because drugs are the primary treatment modality used today. Evidence is mounting that the presence of a pharmacist leads to better drug therapy outcomes at a reduced cost. What an important message to share during a transformational change in health care delivery. Yes, it really is an exciting time to be a pharmacist!

Mr. Eckel is professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is also emeritus executive director of the North Carolina Association of Pharmacists. A lifelong advocate for the profession of pharmacy, Mr. Eckel has lectured on pharmacy issues and trends in all 50 states and has traveled to 6 continents to promote and educate audiences on the role of the pharmacist.