Specialist Pharmacists Improve Outcomes

Aug 28, 2013
Specialist pharmacists at Express Scripts close more gaps in care by focusing their expertise by on a single disease. Here's a real-world example.
  • High Blood Cholesterol
  • High Blood Pressure/Heart Disease

Within the Express Scripts Therapeutic Resource Centers (TRCs), specialist pharmacists develop superior clinical expertise by focusing their knowledge and training on a single disease.

And when they put their unique knowledge to use for patients, this specialization can mean the difference between life and death.

Just ask Nicole Brookbank-Mizer, one such specialist pharmacist at Express Scripts.

Filling Gaps in Care

Nicole recently spoke with a patient who had not filled two of her prescriptions for blood pressure medications. As a cardiovascular pharmacist, Nicole immediately recognized what we call a clinical gap in care – the patient was at risk of serious problems resulting from uncontrolled high blood pressure, such as an increased risk of heart attack or stroke.

So Nicole did what specialist pharmacists do best. She got to the root of the issue.

The Impact of Side Effects on Adherence

The patient was experiencing several side effects – dizziness, headache, flushing and nausea. The dizziness was especially bad and was affecting her everyday activities. The patient had tried several different medications with similar problems. She felt disheartened and unsure about who to call. She was self-adjusting the dosage for one of the medications based on her blood pressure readings, taking it only when she felt it was “needed.”

“We had a long conversation about the importance of keeping her blood pressure consistently in check and focused on potential causes for the dizziness,” Nicole says.

Nicole gave the patient options for alternative therapies and suggested that she make a follow-up appointment with her physician. Based on the patient’s past medical history, Nicole also asked her to consider seeing a specialist to rule out other possible causes for the dizziness.

A More Engaged Patient

They spoke again a couple weeks later. They discussed adjustments to the medication therapy based on the patient’s physician visit, and how well her symptoms and side effects were being controlled.

What was striking to Nicole was the difference in the patient’s attitude toward her own care.

“She remembered me, and was happy to hear from me," Nicole says. "She had much of the information written down and organized for easy reference. It was good to see that she remained invested in her own health and well-being.”

Why They Do It

Nicole has been a specialist pharmacist for several years and loves being able to share her clinical knowledge and help solve patients' problems that may otherwise go unaddressed. But it can be difficult.

“Sometimes conversations with patients can unveil very sensitive subjects, such as loneliness due to the loss of a loved one or helplessness associated with financial hardship. And that can be challenging emotionally," Nicole says. “But I have a unique opportunity to interact with patients on a daily basis.

"It is so rewarding to be able to touch the lives of so many people. Every patient has a unique story, and I love being a part of their journey toward a happy and healthy life. It feels amazing to leave patients with a lasting impression of a pharmacist who cares.”

Specialist Pharmacists Deliver Superior Advice and Care

Interactions like these happen every day in the TRCs. As demonstrated in the chart below, specialist pharmacist intervention can help increase adherence to medication significantly and help improve health outcomes.

superior performance results

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