Delivering positive outcomes and safeguarding patient health are key responsibilities of every member of the healthcare team. Independent pharmacists, as trusted advisers in the heart of their communities, take this responsibility seriously and work tirelessly to have a positive impact.
A key aspect of patient safety that pharmacists directly impact is ensuring safe medication use. Safe medication use is multifaceted and defined by the Institute for Safe Medication Practices, or ISMP, as a “complex process that comprises the sub-processes of medication prescribing, order processing, dispensing, administration and effects monitoring.” ISMP also defines 10 key elements that affect the medication-use process, many of which community pharmacists are directly involved. While each of the 10 key elements of safe medication use are critically important, proactive patient education is often highlighted as an area where a trusted and accessible pharmacist can have a greater impact, especially when inadequate patient understanding may pose significant medication safety risks.
Supporting patient safety takes on a new level of urgency when a national health problem threatens our local neighborhoods. Independent pharmacists are often dedicated to using their knowledge, skills and technology to support prevention and treatment efforts, and the overall improvement of patient outcomes.
When it comes to pain relief, focusing first on ensuring evidence-based care, pharmacists educate patients on appropriate options for pain relief, including over-the-counter medications and nondrug therapies. When opioid medications are prescribed, pharmacists are critical of ensuring that patients fully understand prescriber directions and the risks and responsibilities of the medications. As a part of this risk process, pharmacists can also help patients consider if the potential of respiratory depression is present and recommend co-prescribing of life-saving naloxone to ensure safe use. Health Mart is working to expand the ability for pharmacists to prescribe naloxone directly to patients through collaborative practice agreements and standing orders from prescribers.
Technology also can play a major role in improving patient safety. Health Mart and McKesson are dedicated to the development of a national prescription safety alert system that will focus on identifying patients at risk for overuse, abuse, addiction or misuse of pain medications. The system would provide proactive, real-time clinical alerts integrated into pharmacist workflow, and would address shortcomings of existing state and federal clinical decision support systems, while saving time for pharmacists and prescribers. We continue to advocate that Congress require mandatory e-prescribing of opioids, which would reduce fraudulent or counterfeit prescriptions and improve patient care by reducing errors and improving medication adherence.
Addressing the risks that unused opioid medications pose to friends and family members is another key focus for improving patient safety. Going beyond simply informing patients about the risks, independent pharmacies are increasingly providing specific tools patients can use to safely dispose of unneeded or unused medication.
Health Mart pharmacies have partnered with DisposeRx to provide education and an at-home disposal solution. Each pharmacy received a starter supply of DisposeRx deactivation packets and patient instruction cards to share with their patients. After mixing the medications with water and adding the powdered solidifying agent into the vial, the solution creates a gel that dissolves and sequesters the medication, and allows the patient to place the vial in the trash. Some Health Mart pharmacies have also added in-store disposal take-back kiosks or collection containers in their pharmacies, allowing patients to safely dispose of medications in store.
Although the opioid epidemic is far-reaching and will take efforts from multiple community stakeholders, including the government, public health agencies, prescribers, third-party payers and more, to solve, independent pharmacies can use their skills and expertise in continuing to improve patient safety.
Nancy Lyons is vice president and chief pharmacy officer at Health Mart.