A number of years ago, I was conducting a workshop in Pittsburgh. At some point during the training, I met Dr. Jan Pringle, the director of the Program Evaluation Research Unit in the School of Pharmacy at the University of Pittsburgh.
Jan had an idea: use outcome feedback to improve pharmacy practice and outcome. Every year, large numbers of prescriptions are written by physicians (and other practitioners) that are never filled. Whats more, surprisingly large number of the scripts that are filled, are either: (a) not taken; or (b) not taken properly. The result? In addition to the inefficient use of scarce resources, the disconnect between prescribers, pharmacists, and patients puts people at risk for poor healthcare outcomes.
Together with project coordinator and colleague, Dr. Michael Melczak, Jan set up a study using the ORS and SRS. Over the last 3 years, I’ve worked as a consultant to the project–providing training and addressing issues regarding application in this first ever study of pharmacy.
Anyway, there were two different conditions in the study. In the first, pharmacists–the practitioner most likely to interact with patients about prescriptions–engaged in “practice as usual.” In the second condition, pharmacists used the ORS and the SRS to chart, discuss, and guide patient progress and the pharmacist-patient alliance. Although the manuscript is still in preparation, I’m pleased to be able to report here that, according to Drs. Pringle and Melczak, the results indicate, “that the patients who were seen by the pharmacists who used [the] scales were significantly more likely to take their medications at the levels that would be likely to result in clinical impact than the patients who saw a pharmacists who did not use the scales…for hypertensive and hyperlipidemia drugs especially.”
Stay tuned for more…
Scott, this is a fantastic initiative. My experience is that, as a field, we have severely under-estimated the vital role played by pharmacists (and pharmacist assistants)in health care in general, and specifically behavioral health. I have become quite senstive to the importance of their role over the past decade, largely from two perspectives: 1) working in a primary care site / methadone clinic, I am frequently having discussions with clients about their relationship with their pharmacist (who they see at least as frequently as they see the physician, if not on a daily basis), and they talk about the encouragement, emotional support and good will they receive at the pharmacy; 2) as a Motivational Interviewing trainer, I have had pharmacists attend workshops due to their sincere desire to help clients consistently take medications as prescribed and to help improve overall life functioning. This is a very dedicated group of professionals who too frequently are not included in care planning, yet have the potential for incredible influence on health outcomes and a very valuable role to play.
Please be sure to share the reference for this article once published. And kudos to Jan and Michael for forging ahead with such a forward-thinking initiative.
Regards, rob axsen