Value of Pharmacists in a Patient Centered Medical Home Model

Ishmael Qawiy, PharmD, BCACP

Pharmacists are equipped with the knowledge, training, and skills to assume a greater responsibility in direct patient care within the Patient Centered Medical Home Model (PCMH). Pharmacists are arguably some of the nation’s most accessible healthcare professionals and yet are the most underutilized in chronic disease management. As the healthcare industry evolves from a volume-based to value-based system, stakeholders are finding innovative ways to use ancillary health professionals in a more comprehensive fashion. As drug therapy experts’ pharmacist are sensitive to the barriers impeding medication access for patients along the continuum of care. Studies have shown improved patient outcomes when pharmacists are involved in the management of patients beyond the traditional dispensary roles often seen in community pharmacies.

The Patient Centered Medical Home model is exemplary in utilizing physicians, nurses, pharmacists, social workers, and others to contribute to individualized patient care plans and improve care. Poor communication and care coordination are barriers that block medication management across various settings. Innovative pharmacist-coordinated disease state management programs as a health care or medical home have been shown to result in significantly improved patient outcomes while demonstrating cost savings and improved patient satisfaction.

Over 70 percent of physician office visits for patients over the age of 45 result in at least one drug being prescribed. Studies have shown that 32 percent of adverse events leading to hospital admission were due to drug-drug interactions, an important issue in medication use at home. Only 33–50 percent of patients with chronic conditions completely adhere to prescribed medication therapies. Many patients report cost constraints and the inability to pay for medications as a key factor to their poor adherence. Furthermore, the Commonwealth Fund reported that 58 percent of U.S. physicians stated their patients often have difficulty paying for medications and care.

Pharmacists assume important roles in optimizing therapeutic outcomes and promoting safe, cost-effective medication use for patients in medical homes. With more patients being covered under the Affordable Care Act comes the responsibility to properly treat and manage their conditions. As part of the PCMH, pharmacists are performing a variety of functions from identifying, resolving, preventing medication use and safety problems, to reducing polypharmacy and optimizing medication regimens. As we look for ways to reduce healthcare cost and improve health outcomes through collaborative teams such as the patient centered medical home model, ensuring pharmacists have a seat at the table will be essential maximizing capacity of the healthcare team.

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