Expand and integrate your services: Hear from the trailblazers

Interview with Kelly Epplen and Lisa Dolovich

The identity of pharmacists and pharmacy practice has changed drastically in some parts of the world over recent years. In Canada, the USA and UK, for example, pharmacists have been integrated into primary care teams. “A focus has been placed on . . . increased responsibility for patient outcomes,” says Kelly Epplen, associate professor of pharmacy practice at the University of Cinncinnati, USA.

Dr Epplen will be joined by Lisa Dolovich, professor in pharmacy practice at the University of Toronto, Canada, and colleagues from around the globe, to discuss the expanding role of pharmacists in primary care.

“Pharmacists are increasingly involved in direct patient care, education and training, practice improvement projects, and connecting primary care practices to external stakeholders,” explains Dr Dolovich. “From opioid stewardship to deprescribing, physicians welcome these new roles.”

However, there are challenges, including around remuneration, information technology and professional relationships. Dr Dolovich will share her experiences of integrated services in Canada, including the challenge of developing collaborative intraprofessional relationships. “We will explore how to maximise the value . . . of care delivered by pharmacists embedded in team settings.” She will also describe how to demonstrate value. “How can the everyday data we collect be used to show the value pharmacists provide to patients and the healthcare system? My presentation will describe how the Ontario Primary Care Team Pharmacists network is addressing this issue.”

Dr Epplen says it is imperative that pharmacists are recognised as healthcare providers so they can be compensated for services. Other challenges include a lack of bi-directional IT systems and decreased access to patient health information by community pharmacists. “[This] inhibits their ability to optimise medication-related outcomes,” she says.

Dr Epplen will highlight how pharmacists in the USA have increased their scope in primary care through the use of collaborative practice agreements. “In addition, several states [recognise] ‘advanced-practice pharmacists’ — this allows pharmacists in these states to practise at the top of their licence, often with prescribing responsibilities.” Another key to success is identifying high-risk patients to maximise impact and demonstrate a positive return on investment for organisations investing in pharmacist resources.

Pharmacists have also begun to assume a more established role in healthcare quality. “[They are] participating in population health initiatives aimed at reducing the overall cost of healthcare, while improving patient outcomes,” says Dr Epplen. “This represents an exciting opportunity for pharmacists.”