As the population grows — with the number of pharmacies growing similarly in rhythm — the number of primary care physicians isn’t seeing the same growth.
Studies1 predict a shortage of up to 121,300 physicians by 2030. This means access to primary care physicians is becoming more difficult. However, 9 in 10 Americans have a pharmacy within 5 miles of their home according to NACDS research2. The pharmacist will become more and more important as an overall healthcare consultant.
The movement of providing pharmacists with power to prescribe certain medication started in the UK in 2000. Pharmacists and nurses were given authority to dispense emergency contraception under a physician-signed prescribing protocol. Their initial training included prescriber responsibility, limitation awareness, and relationship building with patients and members of the care team. From that point on, instances (and therefore the importance) of pharmacists offering primary care services has grown each year.
Canada, which faces a shortage of primary care physicians similar to the US3, took the same approach as the UK — empower the pharmacists! Today, most Canadian provinces have laws that expands pharmacists’ scope of practice to allow some form of prescribing power.
The US is now on a comparable path. The first step was implementing collaborative drug management programs and other collaborative practice agreements now available in 47 states4.
Today, the clinical role of a pharmacist demands more authority and recognition. And with pharmacists gaining evergrowing support from advanced information technology, the right to prescribe is just around the corner.
In fact, Idaho has empowered pharmacists to prescribe a range of medications. The new rule allows pharmacists to prescribe medications for cold sores, seasonal influenza, strep throat, and urinary tract infections, as well as statins for patients with diabetes5.
Resistance from physician groups is to be expected, citing Idaho's decision as irresponsible and dangerous3. However, pharmacists in the UK write up to 40% of prescriptions in some communities, with just a 0.03% error rate.
“With great power comes great responsibility”
Empowering pharmacists to prescribe medication could mean:
- Improved access to useful medicine for patients
- Faster reactions to emergencies as well as fewer emergency room visits
- Reduction in the workload for GPs
- Significant decline in drug expenditures
- A new clinical role for pharmacists
- One more step towards centralized patient information
Yet, pharmacists could be shouldered with additional obligations:
- Obtain liability insurance
- Gather information about the patient’s medical history
- Make clinical decisions
- Communicate prescribing information to other health care professionals and the patient
- Monitor and follow-up
Clinical decision-making is complex. With the support of decision-making software, pharmacists wouldn’t just have access to the patient’s drug history, but clinical insights and analysis to identify gaps in therapy where they can prescribe recommended medication.
Moreover, a person visits a GP 3 times per year on average6, but they visit the pharmacy 35 times per year on average7. As such, pharmacies have more opportunities than physicians to track medication adherence or gaps in therapy, and properly advise patients. The increased facetime, alongside increasing access to patient treatments, empowers pharmacists to better serve their patients.
Today’s pharmacists have the clinical knowledge, training, and skills desperately needed in our overburdened health system: patient assesment and monitoring, disease management, medication review, advanced pharmacology, clinical therapeutics, and more. Extending prescribing authority to pharmacists has the potential to optimize medication management and improve the continuity of care and access to medications.
Although physicians and the public will likely need time to adjust to the idea of pharmacists in a prescribing role, pharmacists are already providing prescribing advice in multiple settings. And with the help of carefully designed decision automation softwares, like Amplicare Impact, pharmacists have a strong ally in taking their roles further.
Advanced information technology will likely play a significant role in this adoption, especially considering the shortage of medical practitioners and prescribing “arrangements” that do not currently meet community needs. With an unfamiliar horizon on the way, it’s by leveraging technology that pharmacists will turn new responsibilities into new opportunities.
At Amplicare, we have developed Amplicare Impact, one of few tools on the market providing pharmacists with Gap Therapy and Adherence opportunities. And we are working on improving this tool to support pharmacists who can prescribe medications and have greater autonomy in the direct care of patients.