Bigger role for pharmacists can help primary care doctors

Pharmacists can be a vital addition to primary care practices by addressing barriers to medication adherence, said Hae Mi Choe, PharmD, at the American College of Physician’s annual meeting.

Choe’s institution, the University of Michigan Medical Group in Ann Arbor, has 11 embedded pharmacists and 2 PGY-2 ambulatory care specialty residents who provide care across 14 primary care clinics.

The pharmacists are trained in motivational interviewing, so they can learn why a patient is being non-adherent and recommend strategies to improve.  In addition, the pharmacists have full access to patients’ electronic health records, possess special credentialing privileges enabling them to prescribe medications, and provide medication management to achieve therapeutic goals.

They also do proactive outreach, searching the medical group’s disease registries for patients who are not taking their medications and scheduling 30-minute visits to better understand their adherence barriers, and conduct “Comprehensive Medication Reviews.”

One focus of the pharmacist group has been increasing the percentage of the medical group’s 30,000 primary care patients with hypertension who had their blood pressure under control.

Through efforts that included follow-up with pharmacists, Choe said the group was able to improve that percentage from 72% to 75%.  Physician support is essential, noted Choe.  “None of this is possible unless physicians embrace pharmacists in the practice,” she said.