Rutgers and Pathmark offer something new at the pharmacy counter
Archived article from Nov 21, 2005
By Joseph Blumberg
Rupal Patel, the fifth generation of pharmacists in her family, is ushering in a new era of pharmacy practice in New Jersey. It harkens back to a time when pharmacists were community clinicians with close patient interaction.
“Now we are sitting down with patients, taking medical histories and educating them about medications and discussing lifestyle issues specific to the state of their health – all in coordination with their family doctor, ” says Patel, a clinical assistant professor at Rutgers’ Ernest Mario School of Pharmacy. “These are things the doctor may not have time to do anymore. Most insurance companies only allow doctors about 15 minutes per patient encounter, but the sessions in the pharmacy setting can be up to an hour.”
These types of interactions are normal practice throughout most of the United States. New Jersey, however, is one of a few states somewhat behind the curve. This is expected to change significantly in 2006 when, under the new Medicare drug benefit program, prescription drug plans will be required to develop medication therapy management (MTM) services.
Rutgers and Pathmark Stores Inc. are collaborating to introduce one of the first MTM programs in the state. Patel is providing on-site training for retail pharmacists in the North Brunswick Pathmark store under this premier initiative. Leading by example, Patel is holding counseling sessions with patients while instructing her Pathmark colleagues in the protocols they will need to implement the program. Patel’s goal is to bring a core of their pharmacists up to a level where they can provide MTM services to patients.
Patel explained that an initial patient consultation consists of a medical history interview and a baseline assessment of the patient’s medical condition. The pharmacist conducts basic tests, such as blood pressure, heart rate and glucose levels. Medication reviews ensure that doses are correct and that there are no drug interactions, side effects or duplications, as might be the case with Motrin and Advil – the same drug with different names. Patel also educates the patients on how lifestyle modifications, such as diet and exercise, can better control their medical conditions and encourages them to return for periodic reassessment and counseling.
“We look at patients’ economics. If their financial resources are limited, and they are paying out of pocket for high-cost, newly introduced medications, we might suggest to the physician alternative, less expensive generics,” Patel says. “The bottom line is that if they don’t have the money to buy the meds, they are not going to take the meds. Therefore it is our responsibility to help the patients be more compliant with their meds.”
After a session with the patient, a record of the observations, measurements and recommendations is faxed to the physician, taking the pressure off a crowded schedule and allowing more time for the doctor’s primary role as diagnostician.
“It’s exciting to do all this, taking care of patients and teaching pharmacists,” Patel said. Patel also supervises those Rutgers pharmacy students who have chosen to spend their required five-week dispensing rotation at the Pathmark site. “It will give them a better picture of how the nature of pharmacy practice is changing,” she says.
Return to the Nov 21, 2005 issue
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