Pill Counter, or Medical Sleuth

Last Thursday during a weekly TweetChat about community health centers the topic of drug resistant bacteria came up which led to some interesting comments about pharmacists at community health centers.  I mentioned that we have some pharmacists and pharmacy students at CHC and was asked to provide more information about it.  Unfortunately, I didn’t know an awful lot, so I decided it was best to put things off, do some research and then put up this blog post.

When I started here, everyone told me about the great relationship that CHC has with University of Connecticut’s  School of Pharmacy.  I nodded my head appropriately.  It seemed really important to the people showing me around.

You see, despite taking medications for high blood pressure for years, I’ve never really thought much about my pharmacist.  From my view, she’s always been the person that can decipher my doctor’s hand writing and make sure that I get the right number of pills.  If I’m lucky, she might even notice if medications I’m taking, whether they be prescription or over the counter, might have bad interactions.

It would seem as if moving towards electronic medical records (EMR), the role of pharmacists should be decreasing.  A prescription entered into a good EMR system should be very clear to whoever has access to it and not require deciphering doctors’ scrawls.  A really good EMR system ought to even flag dangerous drug interactions.

Yet a good pharmacist is likely to roll their eyes at my over simplistic view of their job, and they wouldn’t have to look much further than my own medical chart to illustrate the value that they add.

When my doctor first put me on high blood pressure medicine, he suggested that I take an ACE inhibitor.  The next time I went to the doctor, my blood pressure seemed under control, but I was suffering from a persistent dry cough.  After several frustrating visits, where my doctor could not figure out the cause of this cough, I ended up changing doctors.  The next doctor checked me for asthma and other conditions before he noticed that my cough started when I began taking the ACE inhibitor.  He switched me to a different blood pressure medication and my cough went away.

I’ve been on blood pressure medications for quite a while now, and at times I’ve had to change my medications.  This has been complicated by times in my life when money was tight and my insurance was not good, and I sought to find the most cost effective means of controlling my blood pressure.  There have been times that I’ve gone for months with my blood pressure too high, wishing that I could find someone that could find the right combination of medications for me.

This is where a good pharmacist comes in.  As I spoke with University of Connecticut Assistant Clinical Professor Marissa Salvo about her work at CHC, training some of next generation of pharmacists, I came to realize that a good pharmacist isn’t a pill counter, she’s a medical sleuth, helping patients and providers with complicated health conditions find the best combination of treatments.

For health centers that are committed to making the patient the center of care, there is nothing like being able to quickly meet with a pharmacist in the building, or send off information via electronic medical records to a pharmacist for an ‘econsult’, and then getting back to the patient quickly with solutions to their medical problems.

In fact, our chief medical officer, J. Nwando Olayiwola, together with University of Connecticut Assistant Clinical Professor, Stefanie C. Nigro and University of Connecticut Senior Research Scientist Diana M. Sobieraj just published a paper in the Pharmacy Journal of New England  about a Targeted Hypertension Medication Therapy Management at CHC.  The teamwork between doctors and pharmacists has significantly improved the health of many patients.

This is an important topic that more and more primacy care providers are talking about.  On the TweetChat, I learned that the Michigan Primary Care Association has created an online forum for their pharmacists and the Acting today, shaping tomorrow conference being sponsored by the Association of Ontario Health Centres, the Canadian Alliance of Community Health Centre Associations and the National Association of Community Health Centers will have a workshop, “The Power of Teamwork and Technology to Optimize Client Care: Examining the Evolving Role of Pharmacists, Nurse Practitioners and Electronic Medical Record ‘Optimizers’ in Primary Health Care”.

Hopefully more patients and their providers will learn the importance of inviting pharmacists into discussions on how best to handle patients’ health.