TORONTO — Expanding the role of pharmacists in Canada is one solution that will reduce the burden of chronic illness on patients, and save the system an estimated C$1.4 billion to C$1.9 billion dollars over three years, according to a new report released by Arthritis Consumer Experts, the Arthritis Research Centre of Canada and Shoppers Drug Mart.
"Pharmacists already help in the management of chronic conditions, but they can do so much more," stated Domenic Pilla, president and CEO of Shoppers Drug Mart. "Governments have identified chronic disease as an immense challenge and they are investing significant dollars in prevention and treatment of these illnesses; using pharmacists more effectively can help achieve the goal of improving care for Canadians, while at the same time actually reducing costs to the healthcare system."
The report, entitled "Sustainable Solutions Report: A Focus on Managing Complex Chronic Diseases," includes new survey data showing support from physicians and Canadians who want pharmacists to play a bigger role in healthcare delivery.
Complex chronic diseases, like arthritis, hypertension, diabetes, cancer, asthma and chronic obstructive pulmonary disease, affect 37% of Canadians and are a factor in 70% of deaths. Some risk factors for chronic diseases like age and genetics can't be helped, while others are controllable like diet, exercise, or tobacco use. In 2011, the associated medical costs for individuals with these complex chronic diseases were estimated at $42 billion, or 21% of total healthcare spending. This figure is expected to rise to $53 billion by 2015.
How Pharmacists Can Make A Difference
The Shoppers Drug Mart "Sustainable Solutions Report" includes a set of three practical steps governments can take to facilitate pharmacists playing a more substantial role in the management of chronic diseases. These include: 1) enabling pharmacists to develop and manage patient care plans; 2) allowing pharmacists to make prescription renewals and adaptations for specific drug classes; and 3) improving electronic infrastructure and information-sharing between pharmacists and physicians.
Similar measures were outlined in a plan entitled, "9,000 Points of Care: Improving Access to Affordable Healthcare," released by Canada's broader pharmacy community. That plan estimated between C$1.4 billion and C$1.9 billion would be saved over three years by expanding the role of pharmacists in managing chronic diseases. It is also estimated that 1.3 million emergency room visits and 500,000 hospitalizations could be avoided, freeing up to 6.3 million hours of physician time.
Enabling pharmacists to develop and manage patient care plans involving lifestyle management tips and one-on-one or group counseling is one instance of how pharmacists can improve the patient experience while also saving physician time and healthcare dollars.
An example of this type of program is the Shoppers Drug Mart Arthritis Screening that was developed in partnership with ACE and ARC. The screening includes a self-administered joint exam and questionnaire, which can help detect the disease at an early stage. It also helps Canadians with arthritis work with a pharmacist to monitor their symptoms and medication over time to prevent the disease from worsening.
"As someone who has lived with rheumatoid arthritis for 24 years, I know that patients today are eager to work more closely with pharmacists as a key member of their arthritis healthcare team," says Cheryl Koehn, arthritis patient and president of ACE. "Pharmacists can play an important role in helping detect or confirm arthritis and recommending the appropriate healthcare provider if more information or treatment is needed. Your pharmacist is also well-informed about the medication therapies in their store, how to use them, what to monitor, their effectiveness and side effects, and the importance of actually taking them."
Currently, medication nonadherence results in 5% of hospital admissions, 5% of physician visits annually, and contributes C$4 billion to healthcare costs each year.
Physicians and Canadians Support Pharmacists' Expanded Role
As part of the "Sustainable Solutions Report," national surveys were conducted of general practitioners and Canadians to determine their views on the role of pharmacists. It found 88% of doctors say they would be open to having more support from other healthcare professionals to help manage care for their patients with chronic conditions, like arthritis, diabetes, or hypertension.
Almost one-third of family physicians (31%) agree an expanded role for pharmacists will result in patients getting improved management of their chronic diseases. In addition, 40% say patients will get quicker access to some services. Physicians agree that an expanded role for pharmacists can benefit the healthcare system as a whole in ways such as increasing patient adherence with medications (63%), reducing hospital re-admissions because of pharmacists conducting drug reviews (50%), and patients getting ongoing lifestyle and disease counseling from pharmacists (39%).
Canadians also want pharmacists to help them better manage their chronic conditions and would make use of their services. The research found that the vast majority of Canadians (94%) agree pharmacists can play an important role in helping people with chronic conditions manage their health, and 87% would like pharmacists to help make sure they take their medication as prescribed. Research from the Canadian Association of Chain Drug Stores and the Canadian Pharmacists Association reported similar findings.
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