Physicians-to-be getting trained at Rite Aid stores

Picture this scenario: Family medicine residents complete a four-week rotation in a pharmacy, where they learn about the importance of collaborating with pharmacists to improve patient care. They also learn about over-the-counter medicines and how to write prescriptions.

Melissa Somma, Pharm.D., director of the University of Pittsburgh/Rite Aid Patient Care Initiative and of the Community Practice Residency Program at the University of Pittsburgh School of Pharmacy, told Drug Topics, "In the second year of their family medicine residency, the physician residents spend half a day a week for four weeks with the pharmacist. They not only see how the pharmacist works with patients, they are also exposed to the pharmacist's dispensing role and to OTCs. The pharmacist is able to learn more from the physician's perspective, and the physicians can learn more from the pharmacist's perspective."

Somma said the program also sets a precedent for the physician residents. "As they go out and practice, they may think of their community pharmacist a little differently," she said. "They may think, I should reach out to the pharmacist and understand how we can better work together. It also allows the Rite Aid pharmacists to understand the physician's perspective and that leads to better patient care."

The program follows a standard process with patients. "It allows us to understand their concerns and the experience they are having with their medications," Somma said. "We call their physician for laboratory values and we create an assessment and a plan that reflects what the patient and physician have already talked about."

For example, according to Somma, diabetes patients receive an explanation of their disease, lifestyle recommendations, and information on how and when to take medications and how to monitor their medications. They will also learn how to identify whether their medications are working and how to know if there are side effects. "This ensures that the patient is able to be adherent to his or her regimen," she said.

If pharmacists recognize a problem during the dispensing process, Somma said, they let the patient know what the potential problem is. They also contact the patient's physician. "We've had a very positive response from physicians," she said. "There may be a misperception that physicians don't want this. We really work with patients individually for their entire medication regimen. Often, patients' needs are not met anywhere else in the healthcare system. The physicians note that we are seeing patients the way they would, but we are focusing on their medications."

Somma also pointed out that the family physician residents are excited to have a different perspective. Finally she cited a recent report from the Institute of Medicine, which called for collaboration in the community in all points of a patient's care. "This is a way to demonstrate how you can be collaborative in the community," she said.

Somma credited Medicare Part D with creating the opportunity for R.Ph.s to provide medication therapy management services. "These opportunities include heightened awareness by the government and payers. There are payers paying for face-to-face pharmacist services, and we hope there will be more as we see the benefits for patients."