Where are Value-Added Services Performed? Look to the Leaders

Like Comment

We hear much about the performance of cognitive, or value-added services in pharmacy and pharmacy education. Tip of the Week has also focused on a number of particular service initiatives. But just how prevalent is the provision of these services and who is providing them?

Research was performed by Doucette et al to address these questions.1 The study investigators carry out a relatively regular examination of pharmacy workforce issues. In this national survey, pharmacists reported on the extent to which various services were provided. The percent of pharmacies carrying out the services were as follows: immunizations (88.6%); medication  therapy management (76.6%); health screening or coaching (41.0%); disease statement management (24.3%); adjusting medication therapy (24.1%); medication reconciliation (20.0%); complex nonsterile compounding (18.8%);and point of care testing (12.6%). There were other interesting study findings. For example, the average number of these 8 services being performed was 3. The types of pharmacies most likely providing these services were pharmacy chains and supermarket pharmacies, more so than mass merchandiser and independent pharmacies. One of the more highly predictive variables of service provision was the innovativeness of the pharmacy, particularly its leadership. Perceived workload had a positive correlation with services provision (ie, the higher the perceived workload, the more services provided). Additionally, having more than 3 technicians was associated with FEWER services provided.

The authors rightly caution the reader about interpreting the results, since they are correlational and not causative. For example, certain independent pharmacies might specialize in a fewer number of services but carry them out more intensely or frequently. Workload might be perceived to be higher BECAUSE there are more services being provided rather than workload actually facilitating the services. Also, pharmacies with a very high number of technicians might be more focused on large prescription volumes than on service implementation. Still, our Tip readers should take these results into account in regard to certain myths. For example, some chain pharmacies might be highly involved in services provision and be a good place to work if you are interested in services activity. A higher workload does not necessarily preclude the likelihood that services are being provided; and technicians can be extraordinarily helpful in service implementation, IF that is either what they are hired to do or if the mission and goals of the pharmacy comport with services provision. In any event, effective leadership and innovativeness are paramount in the likelihood value-added services provision. Pharmacists interested in being involved with the provision of value-added services should not necessarily be looking for a TYPE of pharmacy, but rather, the mission, organizational structure, and leadership of that pharmacy or pharmacy chain in determining where to work.

Additional information about Organizational Structure and Behavior and Value-Added Services as a Component of Enhancing Pharmacists’ Roles in Public Health can be found in Pharmacy Management: Essentials for All Practice Settings, 4e. 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, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

1Doucette WR, Rippe JJ, Gaither CA, et al. Influences on the frequency and type of community pharmacy services. J Am Pharm Assoc. 2017;57:72-76.

Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California