Creating Value for Consultant Pharmacist Services

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The previous Tip described how pharmacists can become involved with inter-setting opportunities, and how those opportunities are becoming more common with the advent of interdisciplinary care, medical homes, and care transitions. In this Tip, we discuss a more specific opportunity available for a wide swath of pharmacists. The opportunity is in long-term care; specifically as a consultant pharmacist. Consultant pharmacy is actually a federally mandated role created by the 1987 Omnibus Budget Reconciliation Act (OBRA ’87). As long-term care (skilled nursing facility, or SNF) patients might acquire their medications from different sources, SNFs are required to have a contract with a consultant pharmacist to conduct drug regimen reviews (DRRs) for each patient monthly. The DRRs encompass medication therapy, but also medication handling, storage, discontinue (D/C) orders, and other.

Kane-Gill et al evaluated physician perceptions of importance and performance of consultant pharmacist (CP) services in detecting and managing adverse drug events.1 In the control arm of the study, consultant pharmacists conducted DRRs as per protocol. In the intervention arm, CPs provided academic detailing to physicians, responded to alerts from a medication monitoring system, adjudicated system alerts for adverse drug events (ADEs), and provided structured recommendations about ADE management. In the intervention group, ratings of importance increased for all 24 survey questions at the end of the study period, as did the ratings of performance increase for all 24 questions. The researchers concluded that a multifaceted, CP-led intervention comprised of academic detailing, computerized decision support, and structured communication framework can improve physicians’ assessment of importance and performance of CP services.

A pharmacist can work for or even own an independent community pharmacy and engage one or more SNF facilities to contract in providing CP services. A hospital pharmacist can do the same. A pharmacist can own their own CP service or work for any of several larger companies that specialize in providing long-term care services and work almost exclusively as a CP. There are a number of resources to assist with career options in consultancy pharmacy.2 In any event, research indicates that marketing yourself, marketing the services, and demonstrating the value that you and your services provide will go a long way toward their acceptance and uptake by other stakeholders and by patients.

Additional information about Marketing Applications and Creating and Managing Value can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

1Kane-Gill SL, Hanlon JT, Fine MJ, et al. Physician perceptions of the performance and importance of consultant pharmacist services associated with an intervention for the detection and management of adverse drug events in the nursing home. Consult Pharm. 2017;31:708-720.

2Bastain D: Becoming a consultant pharmacist. Consult Pharm. 2017;32:723-725. 

Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California

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Shane Desselle 5 months ago

How many of you were aware of the govt mandated role of pharmacists in long-term care?