As a practicing pharmacist for the past 38 years, I am greatly troubled that the best value in health care is not used in the best interest of patients. Too many people are concerned only that pharmacies are open 24 hours a day, seven days a week; about the price of the prescription; or about the speed with which a prescription can be filled. As a people with higher mortality and morbidity rates than any other group in the country, African-Americans need to look beyond speed, location and price to optimize the value of the services rendered by pharmacists.
Often, pharmacies open 24 hours a day on two or three corners of an intersection and in the supermarket a few blocks away decreases the number of pharmacists available for underserved communities. Emphasis on speed and price limits the time pharmacists spend with those who are on complicated drug regimens and who need consultation on their medication.
While the number of minority pharmacists has increased in recent years, the number of pharmacies owned by minorities has greatly decreased. At the same time, many of the chain operators have avoided our communities, except in a few cities. All this exacerbates the health-care problems of African-Americans, with many health services already abandoning our communities in pursuit of higher reimbursements from insurance companies that favor suburban clients.
For many years, pharmacists were trained strictly on drug use. Today, they also are trained in the various systems of the body and the ways drugs in these systems act. While physicians have great diagnostic skills, their education on drugs is limited. Individuals on multiple medications should therefore draw on the knowledge and skills that pharmacists possess.
Our society largely subscribes to the notion that medications will solve all of our problems—a notion for which we may have to pay a heavy cost in the future since the long-term effects of these agents currently are unknown. Medications only help our bodies deal with the conditions we develop. In diseases such as diabetes and conditions such as elevated cholesterol and hypertension, pharmacists can help you make safe, effective and economical choices on your drug therapy, inform you of the necessary lifestyle changes you need to make and set up monitoring parameters based on the drug and patient. Pharmacists advise physicians daily on drug therapy, giving advice grounded in evidence-based medicine rather than on advertisements or the testimony of drug company representatives. This alone can produce large savings for both the patient and our health system. Pharmacists also educate people on how to read food labels, on the importance of exercising and, most important, how to take a drug and what to expect when taking that drug.
When Congress passed the Medicare Modernization Act in 2003, adding prescription drug coverage to Medicare, it recognized the value of “pharmaceutical care” by including Medication Therapy Management as a benefit. Pharmacists are paid to monitor and advise patients who are on multiple medications. They now are allowed to provide immunizations in every state and manage therapy for patients on anticoagulation therapy. In many instances, pharmacists are the best persons to address community and employee groups on health education.
Many churches have added pharmacists to what used to be “parish nurses programs.” These programs are now called “parish health programs.” Human resources professionals should familiarize themselves with the Asheville Project, which demonstrated how community pharmacists in Asheville, N.C., decreased drug costs for city employees who were diabetics and improved their quality of life, resulting in fewer sick-day absences. The U.S. Food and Drug Administration currently is considering a third class of drugs that would be dispensed without a prescription, but only by a pharmacist. This is just one step toward taking advantage of the education and clinical skills of pharmacists.
Everything you put into your body changes the chemistry of your body. Know who your pharmacist is, make sure your pharmacist knows you and make sure he or she takes the time to explain how the drugs you take work and what adverse reactions may occur as a result. Too often this relationship is overlooked, resulting in more hospital admissions than necessary. While you can buy products like aspirin or Motrin at the local 7-Eleven, you should consult a pharmacist before taking over-the-counter drugs if you are on prescription medication or under the care of a physician for a medical condition. Pharmacists are making a difference every day in improving the quality of life of the medically underserved. They can do even more.
Dr. Leonard L. Edloe, pharmacist, is the CEO of Edloe's Professional Pharmacies, Richmond, Va., and pastor of Antioch Baptist Church in Susan, Va.
By Leonard L. Edloe, Pharm.D.