The Pharmacist's Role in Diagnostic Assessment

As a modern society, we live in a world focused on “now.” Not only are there are certain results that we want to see, but there are also some we need to see immediately—and that means we need devices or methods that can deliver relevant and unbiased results to knowledgeable individuals capable of interpreting the information. Just as improvements in cell phone technology eventually produced the smartphone as a way to make information more easily accessible, pharmacists have undergone their own evolution in the services they provide. However, the profession remains underutilized in multiple health care settings, and many opportunities exist for pharmacists to play a larger role on the health care team. One such opportunity, especially in the modern world of “now,” is the generation and interpretation of diagnostic information.

The terms “diagnostics” and “diagnoses” have been around for a very long time, though our understanding of them has changed. The first and oldest wave of diagnostics involved easily measurable values such as age, weight, gender, skin color, and eye color. While these diagnostics are simple in nature, their value should not be underscored; indeed, some of them remain better prognostic indicators than more technologically advanced diagnostics. The second wave of diagnostics arrived with the implementation of novel tools and newer technologies. Significant advances in the understanding of basic human biology, health, and disease were provided by the abilities to measure more subtle and individualistic physical signs and symptoms, as well as the technologies to evaluate bacterial cultures and gather and interpret biological biopsies. The third wave of diagnostics is a fairly recent phenomenon, and new, interesting discoveries have led to as much confusion as they have clarity. As the scope of diagnostics has grown, so have the duties and responsibilities of those involved. Historically, this tended not to directly involve pharmacists, but that is rapidly changing.

Diagnostic-linked treatment decisions are increasing at a staggering pace. Although empirical treatments in which a practitioner may not know a patient’s specific issues are becoming the exception instead of the rule, diagnostics remains uncharted territory for pharmacists in all practice settings. Like the proverbial train on the tracks, it’s approaching quickly whether we like it or not, and our lack of awareness of this area will not protect us from being run over.

That said, it might serve us well to speculate about how easy it will be to add diagnostic responsibilities to the plethora of services already offered by pharmacists. As pharmacists play a larger role on the health care team, many feel stretched to the point of breaking. How, then, might additional activities, such as diagnostic screenings and interpretations, affect an already stressed reality? Also, diagnostics will contribute complexities and uncertainties that may make perfectly skilled and talented pharmacotherapy experts feel like less-than-competent pharmaco-diagnostic-therapy practitioners.

In upcoming installments of this series, we will begin to unpack the realities of what might be a logical yet challenging path forward for the pharmacy profession. Health care is evolving, to be sure, but getting from the murky and unclear present to a brighter future will require us to navigate some potentially rough stretches without full knowledge of the way forward. However, pharmacists remain among the most accessible health care providers in their communities, and their inclusion in the diagnostic arena has the potential to make a significant impact on patient health.

Haroon Mesdaq is a 2018 PharmD candidate at the Campbell University College of Pharmacy & Health Sciences, where he is also pursuing a master’s degree in clinical research through the school’s dual degree program.

Gary Keil, PhD, RPh, is a board member of the Pharmacy Leadership & Education Institute; national program co-director of Beautiful Mind Strong Body Center, LLC; and co-owner of Evolutionary Health.