The Power of Understanding Patient Needs

Aug 28, 2013
Complex, chronic conditions need specialized care. Express Scripts specialist pharmacists understand unique patient needs and when to go the extra mile.
  • High Blood Cholesterol
  • High Blood Pressure/Heart Disease

As a cardiovascular specialist pharmacist, Ed Dannemiller often encounters patients who have lived with heart disease for many years. Many of them have basically given up on ever feeling better. Given his clinical specialization, 28 years of experience as a pharmacist, and personal experience helping close family members battle chronic conditions including heart disease and stroke, Ed knows his help and guidance could mean the difference between life and death for some patients.

Understanding Patient Needs

“My job is to help patients make decisions that put them on the right track for better health outcomes,” Ed says. “I do whatever it takes.”

That is part of his commitment to the patients he helps every day. Sometimes, “whatever it takes” goes far beyond what is considered part of a pharmacist’s normal workday.

“I can only really help the patient if I understand what is going on in his or her life, get to the root cause of the problem and actively engage the patient in his or her own care,” Ed says.

Recently, Ed’s work with an elderly heart disease patient demonstrated why his specialization and dedication are critical to effective patient-centric care

Going Beyond the Routine 

Ed called a patient to follow up on a couple of missed refills for medications that are important in preventing a possible heart attack or heart failure. Refill reminders are a common tool used by pharmacy benefit managers to help patients be more adherent by ensuring they don’t run out of vital medication.

Ed immediately realized it would take much more than a routine phone call to bring about positive behavior change in the patient.

“Our research has shown there are many things that contribute to nonadherence,” Ed says. “This patient had good intentions but previous setbacks were really affecting the decisions he was making.”

When Medications Don’t Help

The patient sounded depressed and disengaged from his own health, Ed says.

“Rather than tell him what he should be doing differently, I asked him how he was doing and why he wasn’t taking his medication. He said his worsening heart failure made it impossible for him to do even simple tasks without running out of breath,” he says.

The patient had also been recently diagnosed with an irregular heart rhythm, raising the risk of a stroke. When his condition started making everyday tasks seem insurmountable, the patient became depressed. This led to heavy drinking. Combined with his stroke medication, the excess alcohol greatly increased the risk of complications, such as internal bleeding.

“He was stuck in a downward spiral of depression and drinking, but at the same time, he knew full well his decisions were making his illness worse,” Ed says.

His doctor discontinued the stroke medication because of the risk of complications from the patient’s alcohol consumption.

“It was obvious that if I couldn’t help change his behavior, he was going to end up in the emergency room with a heart attack, a stroke or worse,” Ed says.

Turning Good Intentions Into Better Behavior

Ed said he offered the patient help – if he first helped himself.

“I told him I would talk to his doctor about restarting the stroke medication and trying alternatives if he agreed to quit drinking,” Ed says. “It was like I offered him a lifeline. He jumped at it.”

Together they created a plan improve adherence that made sense for the patient and motivated him to get back on track.

“I called a week later and he was a transformed man. He was excited about the progress he had made, was taking all his medications and had not had a drink in five days. He said he felt ready to face his doctor again,” Ed says. “The doctor was thrilled to hear about the patient’s attitude change and really appreciated the practical help and advice I shared.”

Since then, Ed has checked in with the patient, who continues to be adherent to his treatment and to his promise to be a more engaged patient. And he has stayed away from alcohol.

Ed’s intervention turned his life around.

“That’s the privilege of being a specialist pharmacist,” Ed says. “I can help save lives and make a difference in ways that wouldn’t be possible in any other job.”

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