Pharmacy’s role in a modern health continuum
Developing a health care system that puts people at the center of their own care and uses all available resources as effectively as possible has become a consistent goal of most governments. Achieving this goal requires different health professionals to work in collaboration with each other to meet the health needs of patients. In order for that to happen, governments must work with all key professional groups to use all available resources of the system most effectively and, importantly, pharmacists must be recognized as the professional that coordinates drug therapy management. In addition, governments must put in place policies and a regulatory and funding environment that facilitates team-based care and acknowledges and supports the professional competencies of all health professions. These basic points were made in a White Paper prepared for the Alberta Minister of Health. This article, derived from that paper, was prepared to help pharmacists and other pharmacy organizations understand the critical steps needed for individuals and the health system to fully experience and benefit from pharmacists’ skills and services.
Progress has been made
Much has already been achieved by pharmacy and governments working together to optimize system outcomes through improved coordination of drug therapies and the use of care plans to support patient outcomes. There have also been advances in regulation, education and training, testing of new models of care and participation in interprofessional initiatives and in electronic health systems. For example, in 2007, legislation was enacted in Alberta that provided pharmacists with a new scope of practice and entitled them to adapt prescriptions initiated by other prescribers and initiate drug therapy in an emergency. In addition, pharmacists who meet specific requirements can administer drugs by injection, order laboratory tests and can be granted additional independent prescribing privileges. Similar changes are taking place in other jurisdictions around the world. Technician regulation is another example that has fostered an optimization of the pharmacists’ role in direct patient care, as technicians assume greater responsibility for distribution activities.
Despite legislative changes, more is required for the system and patients to benefit fully. Pharmacy education continues to evolve to better prepare pharmacists for their roles and responsibilities in an increasingly complex health care environment with advanced patient health needs. Another important factor is the pharmacists themselves. Rosenthal et al.1 reported in 2010 on the reluctance of pharmacists to take on additional responsibilities, concluding that pharmacist personality traits, including a lack of confidence, fear of new responsibilities, paralysis in the face of ambiguity, need for approval and risk aversion, are at least in part responsible. However, the significant increase in uptake of new responsibilities in Alberta over the past year indicates that a tipping point may have been reached. Overall, the ability of pharmacists to improve patient care and decrease costs has been tested and proven many times.2,3 The future of pharmacy practice clearly lies in the value of the clinical decisions made by pharmacists with each patient encounter.