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Pharmacists: ‘We’re Providers, Too’

At a pharmacists’ conference in Sacramento yesterday, much of the talk centered on the challenges and opportunities inherent in health care reform. The No. 1 challenge for pharmacists, according to one expert, is inclusion in the health care reform discussion.

Most people think of pharmacists as the people filling pill bottles in a back room, but they’re highly trained experts, according to Joseph Guglielmo, dean at UC-San Francisco’s School of Pharmacy. Because drug interactions are complex and varied, including a medication professional in treatment and care decisions could make a huge difference in patient outcomes, he added.

“People forget that we’re providers, too,” Guglielmo said. “The profession of pharmacy is seen now as product-oriented.” But pharmacists can be an integral part of the medical home concept of medicine, he said.

Diane Hendel, CEO of Long Beach Memorial Medical Center, said medication reconciliation — a review of a patient’s medication regimen — is a critical component of better care, and it should be done by an expert, she said.

“We’ve taken the position that pharmacists should be responsible for medication reconciliation because they have the expertise,” Hendel said. “If I’m going in for surgery, I want a surgeon to focus on the surgery, but I want to know I have someone else on board who is an expert in how drugs interact.”

A bill in the state Legislature, SB 493 by Sen. Ed Hernandez (D-West Covina), would expand the scope of practice of pharmacists by allowing them to screen people for diabetes, for instance.

Hernandez addressed yesterday’s convention of the California Society of Health-System Pharmacists, but didn’t mention his specific bill, which is currently stuck in committee.

“We have implementation of the Affordable Care Act moving forward, we will have the exchange up and running,” Hernandez said. “We’re going to make it as easy as possible for the consumer to get health coverage.”

With more people covered by health insurance in California and the ACA emphasis on improving outcomes while saving money, pharmacists can be an important resource in the new medical economy, said Rita Shane, director of pharmacy services at Cedars-Sinai Medical Center in Los Angeles.

“What we know is, we have a fragmented health care system, and medication reconciliation is a part of that. I continue to be amazed at how simple it sounds to make sure medications are accurate, and it’s not so simple,” Shane said.

“Every single dimension of care needs to focus on medication,” she said, pointing out that a sizable part of the patient population doesn’t understand what medications they’re taking, or how and when to take them, and they often don’t take them.

“Clearly team care is the mantra,” Shane said. “How do we leverage our knowledge skills on behalf of the patient? Ensuring the accuracy of the medication list is essential to preventing adverse drug events and harm.”

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