Involving pharmacists in the management of chronic diseases benefits patients, says Wendy Ramey, BSPharm, RPh, CSP, a clinical pharmacy specialist in rheumatology at the University of Kentucky, Lexington. She knows this personally. As someone with rheumatoid arthritis (RA), Ms. Ramey knows pharmacists can play an important role in patient education and encouraging adherence to medications.
Ms. Ramey is one of many pharmacists across the country who work with rheumatologists as part of a multidisciplinary team, a trend expected to increase in the coming years as more pharmacists align themselves with specialty practices.
Donald Miller, PharmD, professor of pharmacy practice at North Dakota State University, Fargo, and a member of the ARP, says the topic of adding pharmacists to rheumatology care teams was the topic of a popular session at the 2018 ACR/ARHP Annual Meeting.1
“With the growing shortage of rheumatologists, I believe we will see pharmacists continue to bridge the gap between rheumatologists and patients,” says Dr. Miller. “Pharmacists are a critical part of a patient’s treatment plan. They provide education, monitor diseases and help manage medication side effects and complications—all things that are often hard for physicians to cover in a 15-minute appointment.”
The Rheumatologist spoke to pharmacists who work closely with rheumatologists to determine how rheumatologists can better utilize them in their practices and ways the two can work together to provide better patient outcomes.
Align Your Practice with a Pharmacist
Adding a pharmacist to a rheumatology practice, either on site or on a consulting basis, can offer many benefits by improving patient compliance and education, resolving medication-related issues and ensuring continuity of care, says Dr. Miller.
Brett Glasheen, PharmD, clinical pharmacist, rheumatology and gastroenterology at University of Utah Health, Salt Lake City, sees a growing trend of pharmacists joining rheumatology clinics, although the majority of growth is still seen at the academic level.
“Funding a pharmacist can be an issue for rheumatologists in private practice,” Dr. Glasheen says. “In academic settings, the cost of a pharmacist is often covered in the pharmacy budget, but for other rheumatologists, it might be beneficial to align their practice with pharmacy services in the local community.”
Jessica Farrell, PharmD, an associate professor of pharmacy practice at the Albany College of Pharmacy and Health Sciences, N.Y., offers an example of this alignment. In 2018, Dr. Farrell pioneered a training program that places a second-year postgraduate pharmacy resident on site in the Center for Rheumatology in Albany.
“At the Center for Rheumatology, patients receive a separate visit with (or a phone call from) the pharmacist regarding new [biologic disease-modifying anti-
rheumatic drug] (DMARD) treatment,” Dr. Farrell says. “We find having the pharmacist cover the details of medication therapy separately saves the rheumatologist a lot of time and allows the patient to feel more comfortable and confident.”