Innovative program establishes pharmacist as health coach, partner

David D. Pope, PharmD, CDE, editor-in-chief of CreativePharmacist.com, has developed and directs an innovative, web-based program titled HealthyHeartClub.com, which offers accountability, encouragement, and education to help patients adopt healthier lifestyles and decrease cardiovascular risk.

Pope illustrated one of its benefits by describing a patient case he recently managed, in which the patient was prescribed metformin. Checking into the online account through which Pope helps her work toward her individual health goals, the patient repeatedly stated that she had not taken her medication properly, so Pope called her to find out what was going on.

She complained of a terrible stomach ache but didn’t want to tell her doctor or Pope that she just couldn’t take the medication. Pope explained that a side effect of the medication was gastrointestinal upset; the good news was that studies showed it appeared to decrease after 2 weeks of treatment. The patient agreed to continue to take the medication for the next 3 weeks; after that, Pope said, if her stomach distress continued, he would help her speak with her physician. Her stomach pains went away and the patient continued her prescription successfully.

“She would not have taken that medicine if she had not checked in with her pharmacist; so that’s the key,” Pope said.

The HealthyHeartClub.com program that Pope describes is designed to empower pharmacists as health coaches who will help patients at risk for heart disease set and reach health goals, including diet, exercise, and medication adherence, and to improve overall health outcomes.

The new program, which was recently featured on the U.S. Government’s AHRQ.gov site as an innovation in healthcare, provides pharmacists the tools and support they need to attract patients who need to lower blood pressure, cholesterol, or weight for an overall healthier lifestyle that ultimately reduces their chances of cardiovascular events.

“As pharmacists, we do disease-state management really well; we know that whenever pharmacists get involved, outcomes improve,” Pope said. “At the same time, we know that the secondary windfall benefit of attracting that chronic care patient to the store means a great deal to the pharmacy, because, for instance, a diabetic patient is going to spend between $6,000 and $12,000 a year. The top 1% spends $28,000.”

Program cornerstones

The program, which was designed through collaboration with pharmacists and feedback provided by physicians and patients, uses the power of the pharmacist to support the physician by providing education, accountability, and encouragement to patients at risk for chronic illness.

The program consists of an initial in-person consultation between the pharmacist and the patient to discuss health-related goals; weekly e-mail check-ins, through which the pharmacist can keep track of the patient’s progress toward goals and offer additional support or guidance; and a monthly group class in which the pharmacist meets with all the members of the program to answer questions and to offer educational presentations on general wellness topics. The Healthy Heart Club team supplies the scripted presentations, and a user-friendly website provides easy-to-understand information on healthy eating and exercise, as well as a variety of tools for both the patient and pharmacist to track progress and to keep the patient’s physician updated.

The time commitment is essentially 1 hour per month for the educational classes and an additional 15-30 minutes a week, during which the pharmacist checks on patients through his or her HealthHeartClub.com account, which Pope says can be integrated into the morning routine. “I check mine while I’m checking in my morning order,” he said.

Pharmacist support

Support for pharmacists is provided by business coaches who explain how to use the tools and how to set up a profile and account within the system; there are also blogs about new ideas or new services in the pipeline, Pope said. Additional support and marketing services are available through the company’s Market Pharm service. And Cardinal Health, which has developed a Specialized Care Center program around the Healthy Heart Club platform, is offering a 9-hour continuing education course on cardiovascular risk reduction at the upcoming Retail Business Conference in Las Vegas.

Most pharmacists charge patients a minimal fee of $15-$20 per month. According to Pope, they have found that patients are more than willing to pay, even in the type of population served by as his pharmacy, which includes many Medicare/Medicaid patients. The company is currently holding discussions with insurance companies and pharmacy benefit managers who are interested in the program.

The company is currently in the middle of a year-long pilot study in collaboration with Cardinal Health, monitoring return on investment and medication adherence, among other things. The company also has just finished designing a study with University of South Carolina that will look more closely at patient outcomes and overall healthcare costs. Pope said the initiative is actively seeking funding; he expects the study to begin within the year.

According to Pope, pharmacists are stepping outside their comfort zones a little, but the effort is paying off in big ways. The demand is out there and the response has been overwhelming, he said.