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APHA Scientific Session and Event Listing

Tricia M. Berry, PharmD, BCPS and Theresa R. Prosser, PharmD, FCCP. Division of Pharmacy Practice, St. Louis College of Pharmacy, 4588 Parkview Place, St. Louis, MO 63110, 314-446-8514, tberry@stlcop.edu

Background: Traditionally, pharmacy practice was product-focused, emphasizing medication distribution processes. Since the concept of pharmaceutical care was introduced in 1990, pharmacy education and practice are evolving to become patient-focused, underscoring the fiduciary relationship between the pharmacist and patient. Recent modifications in pharmaceutical education include a greater emphasis in therapeutics, communication skills, and patient assessment. Shifting to a patient-focused practice requires pharmacy staff to modify processes, behaviors and attitudes. Although pharmacists are very accessible and patients make frequent visits to the pharmacy, pharmacists face several challenges when implementing pharmaceutical care, including the national pharmacist shortage, workflow/workload issues, practice isolated from other healthcare team members that limit collaborative relationships, and patient/healthcare providers' under-appreciation of pharmacists' training and role in optimizing medication usage. Pharmacist interventions have been shown to improve medication usage and asthma morbidity. However, the intensive interventions used are not easily replicated in a typical community pharmacy.

Model Description: The local asthma consortium coordinated a regional, multi-disciplinary effort to improve the care and outcomes for patients with asthma. The Asthma Friendly Pharmacy (AFP) model was created to address the issues mentioned above. A workflow was designed to routinely integrate brief interventions by pharmacy staff for all patients receiving respiratory medications. This workflow can easily be adapted to many community pharmacy settings (e.g., clinic, grocery store or chain). Examples of brief interventions include: educating patients on device technique; inquiring about asthma action plans; evaluating medication therapy for efficacy, side effects, and adherence; identifying medication-related problems; advising and assisting with smoking cessation; and communicating medication-related issues with other healthcare providers. During orientation, pharmacists are shown how to apply their advanced training within the normal workflow and deploy all pharmacy staff to make interventions. The developed fax template makes communication with primary care providers more systematic and efficient. Multidisciplinary training may decrease the sense of geographic isolation and highlight areas for collaboration between local pharmacists and physicians. Media efforts and asthma messages increase patient/provider expectations of the pharmacist. This model emphasizes frequent, yet efficient, pharmacist interventions with patients and healthcare providers.

Implications: The AFP model provides a mechanism to address the challenges of providing patient-focused care. It enhances asthma-related pharmaceutical care services by identifying/resolving medication-related problems; improving communication and strengthening relationships between pharmacists and patients and other healthcare providers; establishing higher expectations for the pharmacist's role in patient care and public health efforts.

Supported by St. Louis Regional Asthma Consortium and CDC U59/CCU723263

Learning Objectives:

• Describe pharmaceutical care and the pharmacist’s role in optimizing medication usage.
• Recognize challenges facing community pharmacists when providing pharmaceutical care.
• Identify brief asthma interventions that can be implemented within a community pharmacy setting to enhance communication and collaboration between pharmacists, patients and other healthcare providers.

Keywords: Pharmacies,

Presenting author's disclosure statement:

Not Answered