JANUARY 2017 - We already know pharmacists can have a positive impact in disease intervention and immunization rates, but it’s critical they seize opportunities to do more through pharmacy services. That was the message by presenters at the latest Pharmacy Forum hosted by the Canadian Foundation for Pharmacy.
Lisa Dolovich, pharmacist and co-lead of the Ontario Pharmacy Evidence Network (OPEN), spoke about missed opportunities in pharmacy services, such as immunizations, MedsCheck medication reviews and interventions available under the Pharmaceutical Opinions program (POP). “In our research we found that 30% of those not vaccinated in pharmacies weren’t aware of the service, and that’s our own missed opportunity,” she said. Similarly, only 36% of MedsCheck recipients received more than one annual review in a six-year period. “I expected more repeat MedsChecks in an era of chronic disease management.”
Over the last three years, the level of POPs is not rising either. “We see the same number of people receiving these every year and that’s another missed opportunity,” she said.
With policy makers focusing on vulnerable populations, Dolovich said pharmacy can also do a better job of integrating information into the rest of the healthcare system. “Overall we’ve found bits and pieces of research that show patients are finding services everywhere and adapting to the pharmacist’s new role and accessibility,” she said. “But we need to spend more time on our own data systems as we have no way of focusing on different groups.”
Private drug plans also untapped
Ned Pojskic, Pharmacy Strategy Leader at Green Shield Canada (GSC), also pointed to pharmacy services as an underutilized resource to help manage chronic diseases and their impact on private drug-plan costs. “There is a limited window of time for pharmacy services to take hold,” he said. “Payers will eventually focus on other strategies that are newer…as there is continuous pressure on employer drug plans for sustainability.”
Through its Pharmacist Health Coaching Cardiovascular program, GSC has taken a proactive approach to getting pharmacists front and centre with at-risk patients. A reimbursed professional service, pharmacists provide blood pressure and cholesterol management support to patients over a series of four appointments. Launched in Ontario and B.C. in 2015, the program has now expanded across the country and more than 630 pharmacists have completed the requisite training program so far.
From the get-go, the program was a standard benefit in all GSC plans. “Only a handful out of 1,200 plan sponsors opted out…so clearly there is an appetite,” said Pojskic.
“GSC has always seen the value in pharmacy services as a core component in drug plans,” said Pojskic, noting that the benefits provider has invested in electronic platforms for patient identification and conducted training sessions with chains and buying groups across Canada to promote the Health Coaching program. There’s also a dedicated program website and email campaign directed to plan members. “We recognize that we have to drive demand, especially with working-age people who are too busy to sit down for an hour with the pharmacist,” he said.
While GSC is pleased with the number of pharmacists who have taken the training, “we have not seen as robust of an uptake on the service itself. And while the company recognizes that change takes time, “we would like to see those numbers go up this year.”
In terms of the future of pharmacy services in the private sector space, Pojskic emphasized that pharmacies need to determine if their focus will be on dispensing or on healthcare delivery and moving patients to better health outcomes. Pharmacists also should be ready to provide these services, which includes proactively reaching out to patients who would benefit most. Finally, pharmacies must be able to ensure that the quality of service is consistently good (via audits, for example).