Last week it was nurses. This week it’s pharmacists. Either way, RM is emerging, bit by bit, as the weapon of choice for holding down healthcare costs. Or at least, so says the Wall Street Journal.
In a story yesterday, the Journal reported on a trial program written up in the Archives of Internal Medicine. In a dozen tracked, randomized trials, regular consultations with pharmacists significantly reduced hospitalization rates for patients with heart failure.
Although the role of the pharmacists varies, generally they help patients stay on their meds, and monitor their basic condition. A similar trial is under way for diabetic patients in 10 cities across the country, in which pharmacists coach diabetics. Both diabetes and heart failure are condition in which regular, consistent use of medication plays a key role. These patients have seen a significant improvement in their blood sugar levels.
The grandmother of all these programs is, of course, the famous Asheville Project. In this pioneering program, the city of Asheville provided city employees with health education, and monitoring and assistance from pharmacists. The program was a classic win-win-win. The patients had greater adherence, better outcomes, lower costs and increased satisfaction with their pharmacists. The city saw lower costs and happier employees. And the pharmacists got to expand their role in the healthcare equation beyond simply dispensing pills. Essentially, by creating an ongoing relationship between the pharmacist and the patient (a relationship, we might add, which is vastly more expensive, complex and difficult than a marketing or patient education campaign) patients were much more likely to stick with their therapies, manage their conditions well, and maximize the benefits they saw.
The bottom line, as always, is that healthcare is at least one part human behavior and participation for each part science. This is especially true for chronic conditions. All programs are not created equal, of course, and your mileage may vary. However, this may portend an expanded new role (or perhaps a return to an old role) for your friendly neighborhood pharmacist. Stay tuned.