NACDS ed sessions discuss medication adherence, travel meds

Among the highlights of the National Association of Chain Drug Stores’ annual Pharmacy and Technology conference are the educational sessions, for which pharmacists earn continuing education credits while learning about the latest trends in pharmacy practice and care.

One of the biggest trends in the retail pharmacy industry is the expansion of services it offers, ranging from health screenings to medication therapy management to vaccinations and immunizations. In August, one education session at the NACDS Pharmacy and Technology show in Denver — the last of its kind as the trade organization prepares to combine its Pharmacy and Technology, Marketplace, and Supply Chain and Logistics shows into one Total Store Expo in Las Vegas in August 2013 — focused on one particularly new and growing vaccination and immunization service.

For most pharmacy retailers, vaccinations are usually of the routine variety, but for a growing number of pharmacy retailers, it also means immunizing travelers against diseases they may risk acquiring while abroad, such as hepatitis A and B, and yellow fever. Seattle-based regional chain Bartell Drugs has offered comprehensive travel clinics at several of its stores for a few years now, and other retailers are doing the same; still others, such as Sam’s Club, offer travelers vaccinations against such conditions as hepatitis. But an education session at the Pharmacy and Technology Conference presented some of the opportunities and challenges involved in travel medicine.

Travel medicine requires expertise on a number of subjects, such as patient education, immunization and pharmacology. “These are things pharmacists are already very skilled at or can easily become skilled at,” the session’s presenter, University of Southern California pharmacy professor Jeff Goad, said. Vaccines are only part of it, he added.

Pharmacy retailers looking to get involved with travel medicine also should consider carrying products travelers will need, particularly if they’re going to developing countries. These include water purification tablets, mosquito nets and insect repellents. In addition, pharmacists consulting prospective travelers should know ways to deal with noninfectious conditions, such as jet lag and altitude sickness.

Travel medicine requires some investment on the part of the retailer, such as setting aside an area to provide services, necessary education for the pharmacist and stocking up on travel-related products, Goad said, as well as collaborative practice agreements with physicians that may be needed for certain vaccinations and medications, travel medicine software and in many states, a special stamp that certifies a pharmacy for delivering yellow fever vaccinations.

Other education sessions attended by DSN Collaborative Care included “Winning Strategies for Medication Adherence and Community Pharmacy,” hosted by CVS Caremark director of strategic development Chris DuPaul, Ateb president and CEO Frank Sheppard and Pharmacy Quality Alliance senior director for quality strategies David Nau. The presentation detailed numbers that should be familiar to many pharmacists: Nearly 3-in-4 patients don’t take their medications as directed; more than one-third of medication-related hospital admissions are related to poor adherence; 1-in-3 patients never fill their prescriptions; and almost 45% of the population has one or more chronic conditions requiring medications. All this adds up to the $290 billion per year commonly cited as the cost of medication nonadherence — though a study by pharmacy benefit manager Express Scripts earlier this year put the figure at more than $300 billion.

The speakers discussed common causes for medication nonadherence and how it affects health outcomes, how to differentiate primary medication nonadherence from secondary nonadherence and various strategies to improve adherence. These included Ateb’s “Time My Meds,” a medication-synchronization strategy that allows pharmacists to focus on patient-centered care by creating “appointments” to manage interactions between the patient and pharmacist, enabling close collaboration between the two and targeting patients with chronic diseases. Next to take the stage was CVS Caremark’s DuPaul, who discussed the causes and related issues of medication nonadherence, drawing on the extensive research the company has conducted on the subject.

On Aug. 28, the last day of the show, Walter Reed National Military Medical Center pharmacist Li Chengqing delivered a session titled “Expanding Pharmacy’s Role in New Care Models: Case Study of Pharmacists as Members of Patient Centered Medical Home Teams,” in which she discussed ways that pharmacists communicate with patients and physicians through bidirectional secure messaging to ensure patients are more engaged in their care. In addition, she described how pharmacists can use the system to see lab results, also identifying ways pharmacists can send condition-specific lab results through the system and offer customized medication counseling for patients with chronic diseases.

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