When patients choose a new primary care physician (PCP), most expect the doctor’s care team might include a nurse practitioner or physician assistant, a registered nurse and a medical assistant. At Harvard Vanguard, as at all of the Atrius Health medical groups, a clinical pharmacist also plays a key role on your medical team.
According to the American College of Clinical Pharmacy, a clinical pharmacist works directly with doctors, other health professionals, and patients to ensure that the medications prescribed to patients contribute to the best possible health outcomes.
Our clinical pharmacists are hard at work, typically behind the scenes, researching the effectiveness of drugs, making glucose test strips more affordable for our diabetic patients, implementing updates to the electronic health record to make it easier for the prescribing clinicians to choose the best medication for their patients, and much more.
Some types of services you can expect from a clinical pharmacist include:
- Drug information: Clinical pharmacists work side-by-side with the internal medicine PCPs at every practice to answer complex questions about individual patients’ drug therapy needs, such as proper drug selection, dosing, laboratory monitoring, patient education and avoidance/treatment of adverse effects or drug interactions.
- Patient care plans: Clinical pharmacists are key contributors at clinical team meetings, at which care plans are developed for patients with complex medical conditions. The clinical pharmacists provide medication recommendations to move patients toward clinical goals such as blood pressure, lipid levels and HgbA1c control.
- Patient medication assistance: Clinical pharmacists often assist clinicians and patients by recommending medications that are covered at a reasonable copayment tier by the patient’s insurance provider. For patients who are unable to afford their medication, clinical pharmacists can help identify simpler or less costly drug regimens.
- Promoting cost-effective prescribing: Clinical pharmacists review a patient’s medical history to determine if individual patients are good candidates for a switch from an expensive drug to a less costly but equally effective medication. Viable recommendations are conveyed to a patient’s PCP on the day prior to the patient’s appointment, allowing the PCP and the patient to discuss and jointly agree upon a potential change of medication. Clinical pharmacists sometimes call patients directly to discuss medication changes that have been reviewed with the patients’ PCPs. On the telephone, the clinical pharmacist explains the switch and makes sure that the patient fully understands how to stop the current drug and start the next, answering any questions and connecting the patient back with his/her PCP if additional questions remain.
- Medication “onboarding” service: At several of our sites, clinical pharmacy services begin right after the patient enrolls with a PCP. Our site staff call new patients to welcome them to our practice. Patients who report that they are taking any prescription medications are referred to a clinical pharmacist. The clinical pharmacist then:
- Contacts the patient to obtain a complete medication history
- Finds out about any current medication-related problems or concerns
- Aranges for new prescriptions as needed prior to the first PCP appointment
- Documents patient-reported current medications and medication allergies into the patient’s electronic medical record.
This medication onboarding service helps the patient have a more successful and efficient first visit, and allows the PCP to focus on any issues that are uncovered.
Our clinical pharmacists are responsible for educating our clinicians and staff about the safe, effective and cost-effective use of medications. They particularly focus on drugs with the most room for error or for which significant savings may be generated while continuing to maintain or improve a high quality of care. They also guide clinicians on response to urgent drug news such as FDA drug bulletins or breakthrough research that changes how patients should be treated most safely.
Each year, clinical pharmacists save millions of dollars in annualized drug costs for our patients and our organization, they help our clinicians keep abreast of the latest in medication knowledge, and they ensure that our patients stay safe and healthy by taking the best medication for their medical condition.