Sometimes the best medicine doesn’t come from a pill bottle or a vial, but from a brisk walk around the block, or a leafy green vegetable. And sometimes, it falls to your local pharmacist to deliver that advice. Such is the sentiment expressed by retired pharmacist Dennis Miller who, upon retiring from his chosen profession, wrote a book in which he shared his thoughts about current pharmacy practices.
“One of the most frequent questions that pharmacy customers ask pharmacists is, ‘I just don’t have any energy. Can you recommend something?’ Miller wrote. “How would customers react,” he continued, “if the pharmacist directed them to the fresh fruits and vegetables section in the drug store rather than to the vitamin section?” He went on to pose a few questions:
- What if customers who asked for a recommendation for constipation were directed to high fiber fruits and vegetables rather than to laxative pills and powders?
- What if a customer mentioned a desire to increase his/her consumption of vitamin C and the pharmacist recommended fresh oranges rather than vitamin C pills?
- What if a customer asked a pharmacist about potassium supplements and the pharmacist recommended fresh bananas rather than OTC potassium tablets?
This approach would seem to have broad support among the pharmacist community, with 95% of pharmacists rating “counselling patients on their medications/conditions” as either “very fulfilling” or “somewhat fulfilling,” in the 2022 CoverMyMeds Medication Access Report.
It’s no wonder then, that so many pharmacies have evolved into “community wellness centers,” one-stop locales in which patients can access a range of health-and-lifestyle products and services. Pharmacists are embracing this, with the National Community Pharmacists Association (NCPA) listing immunizations, blood pressure monitoring, and diabetes education and management as the “top three” wellness services offered. A brief overview of these and other services includes:
- Immunizations. Research by IQVIA revealed that “recommended routine” immunizations are more frequently administered by pharmacists than by physicians. As reported by Pharmacy Practice News, the research looked at data from the 2020-2021 period and determined that “most of the adult COVID-19 and shingles vaccinations took place at pharmacies, and around 60% of vaccinations during flu season took place at pharmacies.
”The 2023 NCPA digest reported similar findings, noting that a “nearly universal” rate of community pharmacists – 87% — administered flu shots. “Most also offer at least one other vaccine,” the analysis added, “such as pneumococcal, zoster [shingles], travel vaccines, and of course, COVID-19.”
Pharmacy-administered immunizations provide a convenient, familiar venue for patients to receive their required immunizations. At the same time, pharmacists help promote good health, while also improving their bottom lines.
- Blood Pressure Management. According to the Centers for Disease Control (CDC), one-in-three Americans has high blood pressure. Within that group, an estimated 34 million are not aware they are afflicted and are, therefore, not taking medication or other steps to address the condition.Not surprisingly, the CDC has enlisted the nation’s pharmacists as front-line caregivers in addressing this important health issue. And pharmacists are responding, with NCPA reporting that almost 60% of community pharmacists offer blood pressure monitoring services. For some, this may include regular blood pressure clinics, or recurring appointments for at-risk patients. Many pharmacies have implemented CDC’s 5-Step Pharmacists Patient Care Process, which instructs pharmacists on implementing individual management plans for their patients. The five steps include:
- Collection of patient history.
- Assessment of that information.
- Development of an individualized plan.
- Implementation.
- Follow-up/Monitoring.
- Health Screenings. According to NCPA, pharmacies increasingly offer a range of health screenings “that not only detect serious undiagnosed conditions, but influence patients to follow up with a physician to receive pharmacologic treatment.” Many pharmacies also offer patient education and counseling services to help patients manage their conditions.
- Point-of-Care Testing: An increasing number of pharmacies offer tests that are “CLIA waived,” meaning they have been exempted from the federal Clinical Laboratory Improvement Amendments (CLIA) of 1988. Eligible pharmacies must apply for and receive CLIA certification. Once that documentation is in place, depending on state authorizations, pharmacies may offer point-of-care tests that include:
- Blood glucose testing.
- Anemia screening.
- Cholesterol Screening.
- Hemoglobin A1C screening.
- Streptococcal Infection testing.
- Influenza testing.
- Urinary tract infection testing.
- Additional Health Screenings. Beyond these important tests, pharmacies may offer screenings for conditions that include:
- Blood pressure monitoring.
- Bone density.
- Nutrient depletion.
- Tobacco Use/Smoking cessation.
- Asthma management.
- Weight management.
- Point-of-Care Testing: An increasing number of pharmacies offer tests that are “CLIA waived,” meaning they have been exempted from the federal Clinical Laboratory Improvement Amendments (CLIA) of 1988. Eligible pharmacies must apply for and receive CLIA certification. Once that documentation is in place, depending on state authorizations, pharmacies may offer point-of-care tests that include:
Health screenings and testing offer convenient opportunities for patients to monitor their numbers and other markers. By offering these services, pharmacists help patients understand and manage their conditions, which hopefully results in improved adherence and outcomes.
Beyond testing and screening, pharmacists are stepping up with a range of innovative services that are expanding the role of the pharmacy as a wellness destination. A few examples include:
- Pet Medications and Supplies. Pharmacy patients come in all shapes and sizes but for a growing number of community pharmacists, they also come with four legs and a tail. That’s because pharmacists are realizing that (a) veterinary medicine has become quite advanced and personalized, which has increased the need for compounding services; (b) many patients – especially elderly patients — find it challenging to obtain the supplies and medications required for their pets; and (c) pet services can offer a lucrative opportunity for pharmacies to generate additional revenue.NCPA cites a few opportunities for pharmacies that include:
- Compounding (i.e., treats, capsules, creams, suspensions, flavorings).
- Specialty medications.
- Vitamins/supplements
- Accessories (i.e., pill pockets, grooming items, toys, leashes, soaps/shampoos).
- Foods and treats (including high-end brands, prescription brands, and hypoallergenic products).
Pet-related sales in the U.S. amounted to $136.8 billion during 2022, according to the American Pet Products Association. This included $58.1 billion spent on food and treats, and almost $32 billion on “supplies, live animals and OTC medicines.”
Clearly, there is demand for pet-related products. And with many animals considered cherished members of the family, pharmacists can provide a great convenience, while promoting the well-being of their pet-owning patients.
- Pharmacogenomics. The National Institutes of Health (NIH) describes pharmacogenomics as the field of research that studies “how a person’s genes affect how he or she responds to medications.” The purpose of pharmacogenomics is to assist prescribers in selecting the drugs and dosages best-suited for each person. Not surprisingly, there is a role for pharmacists in this evolving field, with NCPA listing pharmacogenomics as an important opportunity for community pharmacists. “One avenue for implementing pharmacogenomics is through medication therapy management (MTM), NCPA notes, “where pharmacists assess and evaluate a patient’s complete medication therapy regimen.” In addition, NCPA notes that because of pharmacists’ medication expertise and direct involvement with patients, pharmacists can educate physicians and perform the actual sample collection to be utilized for genetic testing.
- Sports Pharmacy/Medication Management. A 2022 report by the International Pharmaceutical Federation (FIP) notes that pharmacists have become “key players as athlete support personnel.” The report also notes that the practice of “sports pharmacy” is no longer a niche service but instead, “is gaining traction as a recognized specialty on a global scale.” Pharmacists assist athletes with a wide range of services including:
- Knowledge about banned substances and anti-doping research.
- Medication reviews.
- Guidance on vitamins and supplements.
- Education and counseling with regard to diet and exercise, and injury prevention.
- Sales of orthotics, wraps, bandages, and related products.
And the list of wellness-related services offered by community pharmacies continues to grow, seemingly on a daily basis. In many ways, pharmacists have adapted the iconic “If you build it, they will come,” line from Field of Dreams into “If they need it, I will offer it” to describe their approach to patient services.
As pharmacies continue to embrace their role as “wellness centers,” they will find innovative technology-based solutions are there to help. This includes the PrimeRx software system, which provides comprehensive pharmacy management. Among its many capabilities, PrimeRx allows pharmacists to easily track and record all patient interactions, manage pharmacy services, submit payer claims, oversee compliance, and ensure meticulous recordkeeping. Best of all, the system is highly-user friendly, and recognizes that pharmacists’ time is better spent interacting with patients.
