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News & Press: Pharmacy Ownership

Pharmacists Make a Difference Through Team-Based Care

Friday, November 2, 2018   (0 Comments)
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It’s often hard to articulate why an individual student might be influenced by one teacher over another. All qualified in their own right, some teachers seem to resonate more—or less—with certain students.

Perhaps that is what it’s like when patients are cared for by a team of health care providers. As Michelle Thomas, PharmD, CDE, BCACP, put it: patients respond to different team members and sometimes need to hear messages in more than one way before implementing their care plan.

“Team-based care is all about involving the patient, but we have to meet the patient where they are,” said Thomas, who works with a team of health care providers at a small family practice in Virginia. “We all have different styles, and sometimes patients just connect better with someone.”

For some patients, that someone could be the pharmacist who is working on the care team.

Notes from the field

Ashely Abode, PharmD, clinical service coordinator for Realo Discount Drugs in North Carolina, meets with patients under the partnership the community pharmacy has established with an accountable care organization (ACO). She’s formed relationships with several patients over the years, but one case stands out to her. Abode met with a patient who was being treated for depression and learned that the patient was still struggling to control her symptoms. Abode was able to share this information with the patient’s provider and involve the case manager to make sure the patient kept her appointment with her behavioral health provider.

“The care manager, who talked with the patient monthly, was surprised with the amount of information the patient was willing to share with me as a pharmacist,” said Abode. “Through this partnership, I was able to inform the primary care provider of an issue and help resolve the issue by engaging other members of the patient’s health care team to ensure there was adequate follow-up.”

In another example that came about through a different partnership Realo Discount Drugs has in the home health arena, Abode identified a drug interaction between a patient’s chemotherapy agent and a proton pump inhibitor (PPI). “This was a category X interaction because the PPI decreases the concentration of her chemo agent,” said Abode. “I was able to contact her oncologist and get the PPI discontinued.”

Abode noted that pharmacists are not generally on home health teams and that it’s usually the job of software to identify drug interactions. However, in this case, the drug was not picked up by the software.

The medication expert

Team-based care can make providers more comprehensive in their approach since each provider comes to the group with a unique view. Naturally, pharmacists think first about medication-related issues.

Thomas said pharmacists can make the most difference when they focus on their specific area of expertise.

“My team counts on me to bring up the quirky, less common things [known] about drugs,” Thomas added. For example, if she sees a patient with idiopathic thrombocytopenic purpura (ITP), the first thing she thinks of are the drugs that are contraindicated with the condition.

“Recently, when our patient with chronic refractory ITP developed a urinary tract infection, I was the one who suggested we avoid nitrofurantoin for that reason,” said Thomas.

Thomas and her colleagues are also part of an ACO and are held to a very high standard of quality. “It would be overwhelming for one provider to try to meet all 18 of our quality measures,” said Thomas. “It takes all of us and a division of labor to keep track of it all.”

Abode believes a multispecialty team, where each provider brings something different to the table, is the most effective for patient care. “This helps to ensure that each aspect of the patient’s care is managed in the best possible way,” said Abode. “When the team works together and communicates efficiently, the patient has a positive experience, and adverse events are avoided.”

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