Expanding pharmacists' role could help Canadians with chronic diseases better manage their conditions and save Canada's health care system as much as $1.9 billion over three years, according to a report by Shoppers Drug Mart and two health care groups.

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SDM: Pharmacists can aid in disease management

September 5th, 2013

TORONTO – Expanding pharmacists' role could help Canadians with chronic diseases better manage their conditions and save Canada's health care system as much as $1.9 billion over three years, according to a report by Shoppers Drug Mart and two health care groups.

Consultations with pharmacists are seen as a way to help people with chronic diseases better manage their conditions and adhere to their prescriptions.

Shoppers Drug Mart said the report, which the drug chain released along with Arthritis Consumer Experts (ACE), the Arthritis Research Centre of Canada (ARC), includes new survey data showing support from doctors and Canadians who want pharmacists to play a bigger role in health care delivery.

Titled "Sustainable Solutions Report: A Focus on Managing Complex Chronic Diseases," the study highlights three steps that governments can take to empower pharmacists in the management of chronic diseases: enable pharmacists to develop and manage patient care plans; allow pharmacists to renew prescriptions and adapt scripts for specific drug classes; and improve electronic infrastructure and information-sharing between pharmacists and doctors.

Shoppers Drug Mart noted that similar measures were outlined "9,000 Points of Care: Improving Access to Affordable Healthcare," a plan released in April by Canada's pharmacy community. The 9,000 Points report estimated between $1.4 billion and $1.9 billion could be saved over three years by enlarging the role of pharmacists in managing chronic diseases. In addition, it's estimated that 1.3 million emergency room visits and 500,000 hospitalizations could be avoided, freeing up to 6.3 million hours of doctor's time.

"Pharmacists already help in the management of chronic conditions, but they can do so much more," Domenic Pilla, president and chief executive officer of Shoppers Drug Mart, stated Wednesday when the report was announced. "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 health care system."

Complex chronic diseases like arthritis, hypertension, diabetes, cancer, asthma and chronic obstructive pulmonary disease (COPD) affect 37% of Canadians and are a factor in 70% of deaths, according to the Sustainable Solutions Report. In 2011, the associated medical costs for Canadians with these diseases were estimated at $42 billion, or 21% of total health care spending — a figure expected to rise to $53 billion by 2015.

Importantly, some chronic disease risk factors — such as diet, exercise and tobacco use — can be controlled, and that's where pharmacists can play a bigger part in working with doctors and other health professionals to produce better patient health outcomes, the researchers pointed out.

And support is strong for more pharmacist involvement. As part of the Sustainable Solutions Report, national surveys of general practitioners and Canadians were conducted to gauge their views on the role of pharmacists. Eight-eight percent of doctors said they would be open to more support from other health professionals in managing care for patients with chronic conditions like arthritis, diabetes and hypertension.

Also, 31% of family physicians agreed that an expanded role for pharmacists would result in patients getting improved management of their chronic diseases, and 40% said patients would get faster access to some services. Doctors, too, agreed that a larger health care role for pharmacists could increase medication adherence (63% agreed), reduce hospital readmissions via medications reviews (50% agreed), and provide patients with ongoing lifestyle and disease counseling (39% agreed).

Meanwhile, 94% of Canadians said they want pharmacists to help them better manage their chronic conditions and would make use of their services, and and 87% would like pharmacists to help make sure they take their medication as prescribed, according to the report.

"Our research shows that patients with arthritis stand to benefit significantly by having access to pharmacists that can help manage care plans and provide additional counsel, over and above their doctor," stated Dr. John Esdaile, scientific director for ARC. "Managing chronic illnesses like arthritis can be complicated, so it's very helpful for patients to have easy access to health and medication experts like pharmacists."

For instance, the Shoppers Drug Mart Arthritis Screening program, developed in tandem with ACE and ARC, includes a self-administered joint exam and questionnaire that can help detect the disease at an early stage and encourage Canadians with arthritis to work with a pharmacist to track their symptoms and medication over time to prevent the condition 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," commented ACE president Cheryl Koehn, who's an arthritis patient. "Pharmacists can play an important role in helping detect or confirm arthritis and recommending the appropriate health care 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."

The report noted that medication nonadherence results in 5% of hospital admissions and 5% of physician visits in Canada annually, while contributing $4 billion to the nation's health care costs each year.