January 3, 2013
CDC Guide Backs Bigger Role for Pharmacists in Delivering Health Care

Atlanta—The CDC is strongly promoting an expanded role for pharmacists in team-based care.

In a recent document, “A Program Guide for Public Health: Partnering with Pharmacists in the Prevention and Control of Chronic Diseases,” the CDC discusses the increase of chronic diseases with an aging U.S. population and points out, “The role of the pharmacist has expanded beyond just dispensing medications and is evolving into active participation in chronic disease management as a part of team-based care.”

The guide discusses a range of issues involving pharmacists’ scope of practice and cites several examples of benefits when that scope is expanded, such as the advanced pharmacy practice model used by the Indian Health Service and the Veterans Health Administration.

It also reviews pilots programs such as the Asheville Project in North Carolina, where city employees with conditions such as diabetes, asthma, hypertension, and high cholesterol received intensive self-management education through the Mission-St. Joseph’s Diabetes and Health Education Center.

“The employees teamed up with their local pharmacists, who ensured they were using their medications correctly,” according to the CDC report. “The project found that pharmacists improved the clinical outcomes of diabetes patients and reduced overall health care costs.”

It went on to note that when the Asheville Project was expanded to other chronic conditions, 69% of participants with high cholesterol achieved their cholesterol goal versus 33% at baseline, and 81% of participants with hypertension reached their blood pressure goal versus 30% at baseline.

The guide also highlighted a Maryland project as a national example of how pharmacists can partner with other health care professionals to make a difference in patient care. The program, involving business and government entities, uses trained pharmacists to assist patients with proper use of medications, diagnostic testing, counseling, and overall disease management.

Commenting on the program’s inclusion in the CDC guide, Magaly Rodriguez de Bittner, PharmD, CDE, FAPhA, professor and chair of the University of Maryland Department of Pharmacy Practice and Science and director of the Maryland P3 Program, points out, "Our practitioners continue to pioneer new roles for pharmacists in advanced clinical practice and remain committed to a continued partnership with community, institutional, and long-term care pharmacies throughout the state and nation."

That’s in line with the CDC’s position, which states, “Pharmacists extend the health care team to the local community, providing patients with the resources and care they need. In addition, pharmacists are some of the most accessible health care professionals and have a broader knowledge of medicines (prescription and over-the-counter) than any other member of the health care team.”

The public health agency notes that, as of January 2011, 31 states had laws that allow physicians and community pharmacists to collaborate in providing advanced medication management services for conditions such as hypertension and high cholesterol. Another 11 states allowed a more limited scope of practice at that time, although CDC notes that more states have been expanding pharmacists’ roles.

Reimbursement has not kept pace, however. The CDC guide said that as of January 2011, only three state Medicaid programs—Minnesota, Missouri, and Oregon—reimbursed for medication therapy management provided by a pharmacist through individual, face-to-face assessment and intervention.

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