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The Vital Role Pharmacists Play Within Today’s Primary Care Team Contributed by Taylor Hill, PharmD, BCACP, Mary Sauer, PharmD, BCACP, AE-C, CDE and Kyle Walburg, PharmD The CDC1 says 74% of Integrated Into the physician visits involve Clinic Experience drug therapy while 80% of Pharmacists physically loall treatment plans include cated and embedded within medications.2 In 2018, $344 the primary care clinic are billion were spent on 5.8 integral to MTM and fosbillion prescriptions in the ter strong, trusting working United States and that’s prorelationships. Consults over jected to grow by 18 to 26% the phone or via home visits over the next five years.3 are also available and teleTaylor Hill, PharmD, Mary Sauer, PharmD, Kyle Walburg, PharmD Medications only work health is currently under BCACP BCACP, AE-C, CDE if you take them, but two consideration. While proout of every three prescriptions are actually viders can easily refer customers via Epic MTM pharmacists meet with customers filled the first time4 and only half of those get to a MTM pharmacist, they frequently to glean personal lifestyle preferences, forrefilled six months later. Compliance rates seek curbside consults to discuss a specific mulary restrictions and a complete list of decline even further as time passes and barcustomer’s challenge. MTM pharmacists supplements. With an eye toward evaluating riers like affordability and lifestyle multiply. can review physician schedules to identify medication effectiveness, safety and conThe reasons range from not understanding customers with long medication lists and venience, the MTM pharmacist considers why the medication is needed to affordability request time with customers already on the each customer’s health condition, history, and convenience. schedule. The pharmacist can join an existproblem list and clinical notes to identify Medication adherence can impact outing customer appointment or see them after medication regimens that are understandable comes more than the treatment itself aca provider has identified that they would and affordable. cording to the World Health Organization. benefit from MTM. Customers truly valMTM pharmacists are well-versed in Nonadherence accounts for up to 50% of ue MTM pharmacists and say things like, evidence-based guidelines and the clinical treatment failures, 125,000 deaths, and a “That’s the person I see at my doctor’s office nuances of medication selection. By creatquarter of hospitalizations annually in the who saved me $1,500/year on my meds,” or ing care plans collaboratively, pharmacists US. Customers working with their care team “She brought down my A1C from 11 to 7 work in lockstep with primary care providers are key to changing this pattern and saving and helped me reach my goal.” (PCP), specialists and other clinicians un$100 to $300 billion in healthcare costs der a collaborative practice agreement that MTM Impacts Quadruple Aim annually.5 defines where they can start, stop or adjust A recent study published in the Journal of the medications without physician approval. Personalized Med Management American Board of Family Medicine 6 explored North Memorial Health experienced Medication Therapy Management (MTM) the impact of MTM in the primary care quality score improvements following at North Memorial Health takes a personsetting and found that adding a pharmacist’s MTM pharmacist visits (diabetes outcomes alized, holistic view of pharmaceutical care deep knowledge of pharmacotherapy freed increased 14%) and received positive cusby bridging the knowledge gap and making up PCPs to focus on medical issues. PCPs felt tomer feedback about the enhanced clinic each customer an expert in their medicine. better supported, “less burned out” and had experience and ease in managing their mediEquipped with a deep understanding of meda higher quality of work life. They described cations. Providers also felt less overwhelmed ications and treatments along with allergens, seven outcomes including: and burned out after a MTM pharmacist drug interactions and contraindications, • decreased workload joined the care team. 26
March/April 2020
MetroDoctors
The Journal of the Twin Cities Medical Society
