Pharmacist

Pharmacist Amy Schiveley talks with a customer Friday, January 10, 2014, at Lakeview Pharmacy. / Gregory Shaver gregory.shaver@journaltimes.com

Gregory Shaver

If your recent flu vaccine was administered at a pharmacy, you have already sampled the expanded role that pharmacists play in our health care today. A flu shot, though, is just one of many patient-care services pharmacies across the country offer beyond filling prescriptions. From blood pressure tracking to Medication Therapy Management counseling, today’s pharmacists can be a resource for a wide range of information and advice.

In a Medication Therapy Management session, pharmacists can sit down with a customer and go through all of their medications, find out what is working and what’s not, review the purpose of each medication, explain how they work and more, according to Amy Schiveley, managing pharmacist at Lakeview Pharmacy, 516 Monument Square.

Pharmacists already provide some consultation when a customer picks up a prescription, Schiveley said, but MTM sessions take a more in-depth look at the entire medicine profile — including over-the-counter products and supplements — and help the patient better understand what they are taking, why they are taking it and how to take it.

“We go through all of it with a fine-toothed comb,” Shiveley said.

Pharmacists can also help patients understand the risks versus benefits of each medication; explore ways to reduce costs; and work with physicians and insurance companies to figure out what medication options are best for each person, she said.

“It is really about all of us health care providers working together to make these things happen,” Schiveley said.

By giving patients a better understanding of medicines, MTM sessions also help patients be more adherent and compliant in taking their meds, said George Kowalski, vice president of of pharmacy at Roundy’s Supermarkets, Inc

Medication non-compliance is one of the biggest challenges facing pharmacists, and health care as a whole, said Kowalski, of Milwaukee. It is surprising how many prescriptions go unfilled, he said, and about half of all Americans don’t take their medications when or how they should. Such non-compliance not only affects a patient’s outcome, but health care costs in areas such as extended hospital stays, Kowalski explained.

“The goal of Medication Therapy Management is to really bring a patient into their own health care and get them involved,” he said.

Customers are asked to make an appointment for an MTM session and there is a charge for these consultations, Schiveley said. Medicaid is the only insurance that currently covers MTMs, she said, but other major insurers are considering coverage. The American Pharmacists Association recommends an out-of-pocket cost of $2-$3 per minute, Schiveley said.

Long time coming

Such compensation for consultations is something Kowalski said he remembers being told, as a young pharmacy school graduate, would eventually come. That was almost 25 years ago, and while he and other graduates at the time were skeptical, it is now true, he said.

“We are finally seeing that recognition that the services pharmacists provide are valuable and that they do have an impact on a patient’s well-being or outcome,” he said. “It’s been a long time coming.”

Vaccines and beyond

Pharmacists’ role in administering vaccines — which was launched by a law passed in 2008 — really took hold following the 2009 H1N1 flu pandemic, which had people in some areas of the country lined up outside doctors offices, waiting to get vaccinated, according to Kowalski.

That experience set the stage for expanding what pharmacists do, and before long, they were also being certified to administer pneumococcal, meningitis and Tdap (tetanus, diptheria, pertussis) vaccines. And Roundy’s Pharmacy is looking to expand its immunization services to include travel vaccines, he said.

Over the counter

Pharmacists can also help customers sort through all the information — and marketing — surrounding over-the-counter medications and supplements, Schiveley said. When choosing an OTC allergy medication, for example, it can be difficult to decipher which of the many options is most appropriate for your needs, and how much of a difference there really is between those options, she said.

“We give you the information so that you can make the best decision for you,” Schiveley said.

Such education becomes increasingly important as drug manufacturers push to get more and more prescription medications made available over the counter, Kowalski said. For example, when Prilosec — a medication for frequent heartburn — became available OTC within the past 10 years, there were concerns that people might begin using it to self medicate, without knowing if they actually had heartburn or another problem, he said.

“We have more responsibility, as pharmacists, to help people understand the transition from RX to OTC,” Kowalski said.

Customers also play an important role by asking their pharmacist questions. If there is something you don’t understand about the medications you are taking, by all means ask, Schiveley said. “There is no dumb question, ever.”

By alerting pharmacists to any specific concerns, you allow them to address that issue head on. And by being realistic and honest, you enable them to best assist you, she said.

“I’m not going to judge you,” Shiveley said.


Tell your pharmacist

Pharmacists can help you learn how to use prescription and over-the-counter medications safely, and to increase the benefits and decrease the risks.

You can do your part by telling your pharmacist:

• Everything you use. Keep a record of all the prescription and over the counter medicines, vitamins, herbals and other supplements you use and share it with your pharmacist.

• If you’ve had any allergic reactions or problems with medicines.

• Anything that could affect your use of medicine, such as trouble swallowing, reading labels, remembering to use medicine or paying for it.

• When you start a new medication, so that your pharmacist can help you avoid things that don’t mix well with your medicines.

• If you are pregnant, might become pregnant or are breast feeding.

Source: U.S. Food and Drug Administration. For more go to www.fda.gov/Drugs/ResourcesForYou/Consumers/default.htm

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