New law will let pharmacists fill gaps in patient care

7/10/2014

By Kelsey Ryan

By Kelsey Ryan

The Wichita Eagle

(MCT) — A new law took effect in July that will officially allow pharmacists to play a more collaborative role in patient care.

The law, approved by the Legislature earlier this year, will allow the creation of "collaborative agreements" for pharmacists to start and modify drug therapies for patients under the supervision of a physician. It also allows pharmacists to use their expertise to supplement the work of physicians.

The law will have a different impact in clinics and outpatient settings than in the hospitals, pharmacists say. The end goal is to help reduce medication errors.

"It's kind of opened up the door for pharmacists to start thinking about doing it, and now they know they can push forward in providing more pharmacy services," said Tiffany Shin, clinical assistant professor at the University of Kansas School of Pharmacy-Wichita.

Pharmacy practice has changed over the years, Shin said. Until the early 2000s, pharmacists were only required to get a bachelor's degree. Now licensed pharmacists receive a doctorate in pharmacy.

"Because of that, pharmacy students out of pharmacy school are trained more clinically," Shin said. "It's shifting the paradigm from dispensing to providing pharmacy services and utilizing knowledge to optimize medications."

Many pharmacists also have more specialized training in areas like oncology or pediatrics. They work alongside physicians in clinics and hospitals, making rounds to see patients.

The push for the new law came from the Kansas State Board of Pharmacy after board members saw a report by the Centers for Disease Control and Prevention that said Kansas was one of four states in the country with laws that "authorized extremely limited collaborative practice," said Debra Billingsley, executive director of the Kansas State Board of Pharmacy, who helped draft the bill.

The law "codifies what was already being done at the hospitals," Billingsley said.

Joan Kramer, research pharmacy specialist at Wesley Medical Center, agrees.

"We've been doing collaborative practice. It's been happening as an agreement with physicians as captains of the ship for a number of years, but there was nothing on the books that stated what pharmacists can do," Kramer said.

The law could mean more roles for pharmacists in clinic-based practices and teams, Kramer said.

It will help pharmacists, particularly in clinics, fill the gaps with patients who need help with medications, said KU's Shin.

Shin works in a clinic with diabetes patients who have trouble controlling their level of blood sugars.

"I can meet with a patient individually and provide education on diabetes, blood sugar and give insulin," said Shin, who can see a patient after diagnosis and before the patient is seen again by a physician. "I can help bridge that gap."

In hospitals, pharmacists can help meet Meaningful Use, a set of standards set up by Medicare for hospitals to earn incentives for meeting certain criteria, Kramer said.

One criteria is for patients to have medicine reconciliation within 24 hours of admission, which means the hospital should re-evaluate the patient's medications, check for drug interactions and record a medication history.

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