intro

INTRODUCTION TO COMMUNITY PHARMACY PRACTICE

• Dr. Gretchen K. Garofoli, PharmD, BCACP, CTTS, FAPHA

OBJECTIVES

• Identify different types of community pharmacies

• Describe the role of a community pharmacist in patient care

• List activities that a community pharmacist may complete

• Discuss the future of community pharmacy practice

COMMUNITY PHARMACY IN THE NEWS

• Griffith and Feil Drug

• NPR - Capehart and Garofoli

• Sundale Nursing Home Vaccinations

• New York Times

• Harmony at White Oaks Vaccinations

• Pharmacy Staffing Issues

OTHER PHARMACY STORIES IN THE NEWS

• Pharmacy walkout organizers help launch national push to unionize pharmacists and technicians (Published November 8, 2023)

• Patient Safety Issues: Discussion around patient safety over profits, with emphasis on pharmacists supporting worker rights.

• Worker Shortages: Ongoing crisis stretching pharmacy staffs thin, leading to longer hours and potential for mistakes.

• Walgreens Walkout: A small group protested against working conditions.

TRUST IN PHARMACISTS

• Ethics Ratings: Ratings of honesty and ethical standards of medical professionals over time.

• Survey Results (Gallup): How Americans rate the honesty and ethical standards of various professions:

  • Nurses: Highest rating of honesty (85% very high/high)

  • Pharmacists: 64%

  • Decline noted in ratings from 2019 to 2023 across many professions, including pharmacists (from 64% to 55%)

COMMUNITIES AND ACCESSIBILITY

• Community pharmacists are the most accessible healthcare professionals, with nearly 90% of the population living within 5 miles of a pharmacy.

• Value Proposition: Effective health interventions through frequent patient interactions.

TYPES OF COMMUNITY PHARMACIES

• Independent

• Outpatient clinics (POC, Geisinger)

• Supermarket pharmacies

• Chain pharmacies

• Mass-merchants

LARGEST PHARMACIES BY TOTAL RX REVENUE

• CVS (chain and mail order)

• Walgreens

• UnitedHealth Group (Optum Rx)

• Walmart

• Cigna (Evernorth/Express Scripts)

• Kroger

• Rite Aid

• Others including Albertsons, Publix, and Costco

FUTURE OF COMMUNITY PHARMACY

• Emphasis on fast, accurate, and affordable filling of prescriptions.

• Introduction of Enhanced Services Networks: transitioning pharmacy roles towards patient care and health outcomes improvement.

JOB SATISFACTION IN PHARMACY SETTINGS

• Job satisfaction varies across settings:

  • Academia, hospitals, ambulatory care clinics, and independent pharmacies: (~84%)

  • Retail settings: (64%)

STAFFING OF COMMUNITY PHARMACIES

• Key staff include:

  • Pharmacists

  • Pharmacy residents

  • Interns

  • Technicians

  • Clerks

  • Delivery drivers

  • Cleaning personnel

BUSIEST TIMES IN COMMUNITY PHARMACY

• Notable busy periods:

  • Mondays

  • Mornings on any day

  • The day after a holiday

  • Specific days like January 2nd, July 5th, and Tuesdays after holidays.

COMMUNITY PHARMACIST ACTIVITIES

• Includes:

  • Patient counseling

  • OTC self-care recommendations

  • Compounding

  • Immunizations

  • Screenings

  • Medication therapy management

  • Disease state management

  • Conversation and patient engagement

ANSWERING THE PHONE IN PHARMACIES

• Best practices for professionalism:

  • Answer within three rings

  • Use proper greetings

  • Take notes during calls

OVER-THE-COUNTER (OTC) SELF-CARE RECOMMENDATIONS

• Important considerations:

  • Assess patient conditions when making recommendations

  • Account for medical issues like diabetes and high blood pressure.

COMPOUNDING

• Focus on non-sterile compounding with varying complexity.

• Some independent pharmacies focus specifically on this service.

IMMUNIZATIONS

• Requirements and procedures for pharmacy immunizations:

  • Pharmacists and technicians must complete training programs.

  • Authorized to administer various vaccines under specific guidelines.

CLINICAL SERVICES

• Medication Therapy Management (MTM) and Disease State Management (DSM)

• Activities like clinical medication synchronization and adherence packaging are highlighted.

COMMUNITY PHARMACY ENHANCED SERVICES NETWORKS (CPESN)

• Focus on improving clinical outcomes through enhanced services.

• Emphasizes community engagement and adherence to high standards.

NEW OPPORTUNITIES IN WEST VIRGINIA PHARMACY

• Tobacco Cessation: New protocols allow the initiation of non-controlled medications for qualified patients.

• Hormonal Contraception: Protocols allowing pharmacists to initiate therapies under specific guidelines.

STUDENT PHARMACIST ENGAGEMENT

• Encouraged to participate in organizations, internships, and advocate for the profession.

ASSIGNMENT

• Listen to a specific podcast and summarize learnings regarding advocacy for pharmacy.

QUESTIONS?

• Contact Dr. Gretchen Garofoli at Gretchen.Garofoli@hsc.wvu.edu