Pharmacists as Key Players in Managing Chronic Conditions | ACCP 2024
Pharmacist management of chronic conditions can lead to improved patient outcomes.
The role of pharmacists in health care has evolved significantly, extending beyond traditional medication dispensing. More than ever, they are actively involved in managing a wide range of chronic conditions. Two posters presented at the American College of Clinical Pharmacy 2024 Annual Meeting showcased the impact that pharmacists can have on improving patient outcomes, particularly in the areas of mental health and respiratory diseases.
Pharmacist handing patient medication / J Bettencourt/peopleimages.com - stock.adobe.com
Ambulatory care pharmacists can significantly improve depression and anxiety outcomes, but more education is needed on general anxiety disorder-7 (GAD-7) monitoring due to high comorbidity, according to one poster presented at the meeting.1
Although ambulatory care pharmacists are increasingly involved in managing a wide range of diseases, including anxiety and depression, there is limited research on the specific benefits of their interventions within primary care settings. The current study aimed to evaluate the impact of pharmacist-led interventions on objective measures of anxiety and depression.
The retrospective cohort study included 124 adult patients who had at least one documented visit with an ambulatory care pharmacist between February 2020 and August 2023 to manage their depression and/or anxiety.
The primary outcome was achieving a therapeutic response, defined as a 50% or greater reduction in either GAD-7 or patient health questionnaire-9 (PHQ-9) scores. Secondary outcomes included changes in these scores, factors associated with therapeutic responses, types of pharmacist interventions, and percentage pharmacogenomics used.
After receiving care from an ambulatory care pharmacist embedded in primary care, 48.4% of patients achieved a therapeutic response as measured by the PHQ-9. Although two-thirds of patients also had comorbid anxiety, GAD-7 scores were not available for analysis in 57.4% of these cases.
On average, patients had 4 visits with the pharmacist and received 2 interventions. Both PHQ-9 and GAD-7 scores showed significant improvements of 35.7% and 34.6% at approximately 6 months follow-up, demonstrating the value of ambulatory pharmacist interventions.
According to another poster at the meeting, pharmacists can play a significant role in optimizing chronic obstructive pulmonary disease (COPD) management in primary care settings.2
COPD is a progressive lung condition that causes persistent symptoms that can worsen dramatically and lead to life-threatening exacerbations. Although international guidelines provide clear recommendations for managing COPD, only a third of patients receive the recommended treatment.
The current study investigated the effectiveness of pharmacist interventions in improving COPD symptoms among Veterans through a COPD primary care service.
The COPD Coordinated Access to Reduced Exacerbations (COPD CARE) program was established within the Department of Veteran Affairs to enhance COPD care using pharmacists. The program focused on implementing evidence-based strategies to improve the health of Veterans with COPD.
Data from 328 Veterans who participated in the COPD CARE program between September 2020 and February 2024 was collected to evaluate its effectiveness.
Veterans participating in the COPD CARE program received an initial wellness visit, during which pharmacists provided education on best practices and implemented interventions to address COPD systems, and baseline COPD symptoms were recorded via the COPD Assessment Test (CAT). Patients’ CAT scores were measured again one month after the initial visit.
The CAT was a questionnaire that measured the impact of 8 COPD symptoms on overall health ranging from 0 (no symptoms) to 40 (severe symptoms).
On average, patients experienced a significant improvement in their COPD symptoms of 3.2 CAT score points between the initial wellness visit and follow-up visit (95% CI, -4.0 to -2.5). Additionally, Veterans who received medication adjustments from pharmacists were more likely to experience a clinically meaningful improvement of at least 2 points or more (P < .001).
“The associations between medication changes made by pharmacists and COPD symptom improvement further promotes the role of pharmacists to optimize COPD management in primary care settings,” concluded investigators.
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