COMMUNITY PRACTICE

Little state makes big R.Ph. care moves

Delaware pharmacists are cashing in on patient counseling opportunities created when their professional association forged links with state government officials and other healthcare organizations.

Smoking cessation, diabetes education, and a medication management program for senior citizens are among the opportunities seized by the Delaware Pharmacists Society (DPS), said executive director Pat Carroll Grant. Not only do participating pharmacists have a chance to learn new skills to help their patients, they get paid for doing it. And DPS' efforts have earned a nomination for the Pinnacle Awards given annually by the American Pharmaceutical Association to recognize contributions to healthcare quality through the medication use process.

The biggest project up to now is smoking cessation, which began when the DPS answered a state call for proposals to train counselors, said Grant. So far, 54 pharmacists have been trained to help patients who want to kick the habit, but she hopes to train an additional 21 R.Ph.s in upcoming sessions. Funded through the state's share of the tobacco settlement, the program gives smokers the option of telephone counseling or face-to-face sessions with a pharmacist. The pharmacists are paid $135, which includes the initial session and two follow-up visits.

"We also worked with our partners to build a network of pharmacies that would accept a voucher program for nicotine replacement products," Grant said. "We worked with our pharmacies and pharmacists so that patients can take the voucher to the pharmacy of their choice and get the product at no charge. Then the pharmacy directly bills the state."

The DPS smoking cessation program is supervised by Dave Wrzesniewski, pharmacy manager at a Super G in Wilmington. He is the pharmacists' support person and collects their documentation data. He took the project manager job after Grant promised him it would take only 20 hours a month. "She told me a big white lie," he laughed. "It started out that way, but as it's grown, I work about 60 hours a month. But I love it because the program is expanding. Folks who participate have heightened their counseling skills, and we've given them additional tools and turned them loose. They're enrolling people and they're seeing results, which makes everybody happy. Delaware benefits and the pharmacists benefit."

The Delaware contingent paid homage to Fred Mayer, Pharm.D., M.P.H, who heads the Pharmacists Planning Service in San Rafael, Calif., and is generally acknowledged as the champion of the pharmacist's role in public health. His accomplishments include the creation of the Great American Smokeout, which has become a November tradition.

"We owe all our success in smoking cessation to Fred Mayer," said Nancy Lewis, Pharm.D., M.P.H., a self-employed grant writer who works with DPS. "When we first thought of applying for the proposal, it was Fred who provided us with the advice, contacts, and background information that helped us gain support for our proposed program. Fred's been our adviser and mentor through it all."

The latest coup scored by DPS is a contract to develop and administer a medication management program for seniors funded through the Delaware division of services for aging adults and persons with disabilities in cooperation with the Nemours Health Clinic department of pharmacy. As part of a media campaign, pharmacists will conduct instructional programs for seniors, which will include one-on-one brown bag sessions. The one-year program will conduct more than 60 presentations. Participating pharmacists will be paid about $100.

Right now, the reimbursements are funded by grants, but the idea is that once pharmacists hone their skills and gain confidence by actually providing services, they'll not only continue but also charge a fee when the grant money runs out.

"A key is getting pharmacists used to doing these things and billing for it, so that when the funding stops, they have a built-in mechanism to say, 'This is what we do and this is what we charge for it,'" said Lewis. "Pharmacists need that practice because charging for their services is a very foreign concept to pharmacists. They've got to get used to seeing that it's OK to ask for money and that people value what they do."

Reaching out to other organizations and touting what the pharmacist can contribute to a joint effort is the secret of DPS' success, according to Lewis. It also helps that the participating pharmacists are able to keep their end of the bargain by delivering services that patients appreciate.

"The whole key is partnering, letting everyone know pharmacists do wonderful things," said Lewis. "That way, when proposals come out, it gives us an opportunity to participate."

Carol Ukens

Carol Ukens. Little state makes big R.Ph. care moves.

Drug Topics

2002;5:35.