Challenges Ahead in the Pharmacy Field
Despite all the progress made in the pharmacy field – especially in recent decades – there are still challenges to address. For example, how can pharmacists better help patients follow doctors’ orders when it comes to taking prescription medication? What can they do to help improve health literacy so that Americans can make the best health decisions? How can policymakers play a role in ensuring there are enough pharmacists available for every community? If exploring these issues sounds intriguing, then you may want to consider how pharmacy may be the career for you!
Non-Adherence to Medications
Did you know that almost three out of every four Americans do not take their medication appropriately? This critical statistic plays a role contributing to about 125,000 deaths each year. The health care field uses a special name for properly following a prescription: adherence. Medication adherence means that patients take their medicines as prescribed. The lack of adherence, or non-adherence, is a significant problem in the U.S. Health complications that result from low levels of adherence, which not only put patients at risk for harming their health, but also cost the country an estimated $100 billion each year in treatment and care costs.
Fortunately, pharmacists can play an important role in increasing adherence. One study showed that visits from a pharmacist considerably improved adherence among elderly patients. Other researchers have pointed to pharmaceutical counseling, which improved proper medication use by nearly 50 percent in some cases. In recent decades, the pharmacy field has been recognized for playing a significant role in increasing adherence by developing new tools and techniques to encourage patients to follow directions for prescription usage. In fact, the most recommended method to increase adherence is to strengthen the patient-pharmacist relationship. Therefore, it is important that pharmaceutical professionals have good communication skills and enjoy working with people.
Inadequate Health Literacy
Almost 90 percent of American adults have difficulty understanding and using health information provided by health care facilities and other educational resources. For these individuals, understanding health prevention, care and treatment can be very difficult, and may mean that they skip doctors’ visits, use medications incorrectly or do not know how to manage their own health, particularly if they have chronic or long-term health issues such as diabetes.
Health literacy is a person’s ability to understand basic health information needed to make good and appropriate health care decisions, such as when to visit a doctor and how to follow the directions on a prescription. Individuals who are not adequately health literate are more likely to be hospitalized or take their medication improperly. In the U.S., inadequate health literacy impacts the whole population, but minority groups and low-income populations are more significantly affected. These groups already have more limited access to health resources, and poor health literacy can make the situation worse.
Pharmacists, along with other health care professionals, can play an important role in helping to address health literacy challenges by providing clear and easy to understand health information and guidance. As a primary link between physicians and patients, pharmacists can also play an important role in communicating culturally-relevant information to patients from different backgrounds.
Pharmacist Shortages in Rural America
Sixty-five percent of Americans in rural communities do not have enough health care professionals, including pharmacists. The lack of pharmaceutical services increases rural residents’ dependence on public assistance programs and requires them to travel further distances to receive health care services. About 20 percent of Americans live in rural areas, but only 12 percent of the country’s pharmacists serve this population – resulting in a significant number of demands that are not met. Since there are so few pharmacists in these rural areas, numerous patients turn to hospitals (many of which are understaffed) for their pharmacy-related needs. While the rest of the country continues to decrease the gap between pharmacist supply and demand, rural areas are still lagging behind. In an effort to attract more pharmacists, some states have established loan forgiveness programs for professionals serving rural communities. These programs give pharmacists money to pay off any debt from their schooling in addition to the salary they earn, which can be a very appealing offer to recent pharmacy graduates looking to make an impact on local communities.
Newsmakers and Game-Changers
The role of pharmacists has grown over time, and now pharmacists are communicators, educators, innovators and consultants. Pharmacy game-changers and newsmakers make invaluable contributions to the field, including providing medical care to people in rural areas and countries plagued by epidemics and natural disasters; developing more effective vaccines; and founding organizations that help those working in health care. Here are a few profiles of notable pharmacists from non-profit organizations, universities, research organizations and the United States Armed Forces, who are making a difference today.
Janice Lee is a pharmacist committed to bringing quality medical care to people in crisis through her volunteer work for Doctors without Borders/ Médecins Sans Frontières (MSF). MSF is an international organization that provides emergency relief to over 70 countries around the world plagued by armed conflict, epidemics and natural and man-made disasters. These countries often have little or no access to health care. After working as a pharmacist on projects in Liberia and Zimbabwe, Janice joined MSF’s Access Campaign, which works to improve access to life-saving and life prolonging medicines, diagnostic tests and vaccines for patients and to develop new ones. One of her main roles involves finding potential new sources for drugs that could be of use to MSF’s work treating patients in developing countries. She also works closely alongside medical teams and pharmaceutical companies to help heighten industry awareness surrounding the needs of patients in developing countries, and in particular, their dependence on generic drugs. As she explains in a recent interview with MSF, the existence of affordable generic drugs is essential to improving health care in poor countries.
For more information about MSF, please visit: www.msf.org.
For more information about MSF's Campaign for Access to Essential Medicines, please visit: http://www.msfaccess.org/.
Even before becoming a licensed pharmacist, Kyle Burcher worked to improve the quality of pharmaceutical health care on the local and national levels. While studying at the University of Georgia College of Pharmacy, he actively participated as a member of the school’s chapter of the American Pharmacists Association Academy of Student Pharmacists (APhA-ASP). Through APhA-ASP, Kyle volunteered at a multicultural health fair where he and 50 other pharmacy students provided health care information and administered free screenings for chronic illnesses. Seeing that many of the individuals eligible for this free service were part of the surrounding community’s Hispanic population, he approached the university’s Spanish Club and asked its members to volunteer as translators. His initiative to provide Spanish language translation enabled over 350 patients to utilize the service, exemplifying Kyle’s commitment to improving pharmacist-patient communication.
On a national level, Kyle advocates for changes in national legislation to improve health care pharmacy. For example, in 2010 he organized a campaign that encouraged other pharmacy students to write to their Congressional Representatives about America’s health care needs. In 2011, Kyle participated in the National Association of Chain Drug Stores’ Rx Impact Day in Washington, D.C. During his visit, he met with Congressional members to discuss laws that could benefit both pharmacists and patients. Kyle’s hard work reflects his belief that pharmacists have an obligation to serve, educate and protect their communities.
Lieutenant Col. Gwendolyn Thompson
Lieutenant Col. Gwendolyn Thompson has served as a pharmacist in the United States Army for over 20 years. She began her career as a pharmacy technician for the armed services, after which she returned to school to earn her Doctorate of Pharmacy. Gwendolyn now serves as the Chief of the Pharmacy at Carl R. Darnall Army Medical Center, which provides medical services to more than 145,000 patients and fills 4,500 prescriptions a day. Gwendolyn has been called upon for her pharmaceutical knowledge by army pharmacies across the U.S., as well as in foreign countries, such as Germany and Iraq.
During her career, Gwendolyn founded the first-ever pharmacist-run clinic specializing in disease state management, including asthma, diabetes, and hypertension, among many others. She also received the first Army Pharmacy Student Grant, which allowed her to conduct an extensive study of military medical clinics to identify the most effective pharmacy practices and challenges faced by the clinics. Gwendolyn’s work as a pharmacy consultant to the Office of the Surgeon General’s Pain Management Task Force helped establish Integrative Pain Centers in various military medical centers. These centers use holistic approaches in conjunction with cutting-edge technology to provide comfort to soldiers and other patients dealing with lasting pain.
Like many other professionals in pharmacy, Thompson was drawn to the field by the idea of being able to help patients and provide health care support to treat medical conditions. Despite all of her accomplishments and awards, Gwendolyn has stated that her most rewarding experience to date was working at the Army’s largest combat hospital in Iraq, where she served patients fighting on the front line. In addition to caring for American soldiers, her interactions with Iraqi counterparts allowed her to share information about new medical developments and how to help wounded individuals. Due to her achievements in this specialized field of pharmacy, Gwendolyn was selected as one of three finalists for the 2011 Next Generation Pharmacist Award: Military Pharmacist of the Year. The awards program created this special category in 2011 to recognize military pharmacists who must deal with unique challenges in their field of health care.
Breakthroughs and Innovations Under Investigation
Breakthroughs in the pharmacy field play a major role in improving the health care system. They may range from the discovery of new medicines to the application of technology in an unprecedented way. These kinds of medical advancements have helped to make the quality of life better for people facing all kinds of conditions, from HIV to cancer to diabetes, and also help healthy people stay that way. Following are a few discoveries that have already had a major impact on improving patient care and modernizing the pharmacy field, along with some examples of innovations currently under investigation.
The World’s Largest Artificial Neural Network
In 2012 Google[x] and Stanford University researchers teamed up to build the world’s largest artificial neural network designed to simulate the human brain. A year later, Andrew Ng, director of Stanford’s Artificial Intelligence Lab, and his team have developed another neural network that is over six times the size of the one built in 2012.
This breakthrough is significant it means that we are progressing towards being able to give robots human-level intelligence. Neural networks model the way that biological brains function – using mathematics – the networks allow a machine to learn to think the same way that humans do using parameters, which are the digital version of neural connections. According to PopSci the new artificial neural network created by Ng and other Stanford researchers is 11.2 billion parameters compared to the 2012 model, which was made up of 1.7 billion parameters.
“It gives me hope –- no, more than hope –- that we might be able to do this,” said Ng, who was also part of team who built the Goggle [x] neural network. “We clearly don’t have the right algorithms yet. It’s going to take decades. This is not going to be an easy one, but I think there’s hope,” he recently told Wired. While this newest network is the largest ever built it pales in comparison to the human brain’s 100 trillion connections.
Smart Stiches—Sewing Up with a New Type of Sutures May Speed Up Healing
Stiches used to sew up wounds are also called sutures. These stiches have ultrathin silicon sensors that are thin enough to thread through needles and would help monitor wounds and accelerate the healing process. The electronic stiches were invented by John Rogers who is a professor of materials science and engineering at the University of Illinois at Urbana-Champaign.
According to Discovery.com, Rogers and his team were able to use the sutures and knot them without harming the sensors during animal tests. The invention can be used as traditional stiches that also monitor elevated temperatures, thus indicating infection, apply heat to help the healing process, and eventually deliver medicine.
Blood Monitoring Patch—an Innovation to Test Blood Without Needles
A company named Sano Intelligence is developing a small patch that continuously monitors an individual’s bloodstream in order to detect abnormalities. The current prototype can measure glucose and potassium levels and the materials for making the patch are inexpensive (the materials for a sensor with a seven-day lifespan currently cost $1 to $2). However, Sano Intelligence is still working out some of the patch’s issues including making it waterproof.
According to Fast Company magazine, Sano Intelligence is working on establishing a pilot study with major research-focused medical institutions, and the blood monitoring patch may be ready for release by the middle of 2013.
Have you ever wondered what it might be like to work with a robot? Well, some pharmacists do, and many more might work alongside robot pharmacists in the future. As of now, robots are used mainly at pharmacy hospitals, but pharmaceutical experts predict that the technology will reach local drug stores in coming years.
The Medical Center at the University of California San Francisco uses the PillPick® automated packaging system in conjunction with RIVA (Robotic IV Automation), a robot that dispenses liquid medication; at New Jersey’s Holy Name Medical Center, robot pharmacists package, store and dispense prescriptions; and one children’s hospital in Ohio uses robots to prepare intravenous (IV) drugs.
Robots are not intended to replace pharmacists, who are integral to delivering patient care, but they can help a pharmacist do their job by speeding up manual tasks that don’t require their professional skills. In fact, pharmacy managers who have purchased and implemented this new technology report that the machines are easing pharmacists’ work load, allowing them to spend more time with patients and devote attention towards advancing various drug therapies. An increased focus on patient interaction may allow pharmacists to treat the unique health care concerns of each individual. However, robot pharmacists are still very expensive, so the likelihood of seeing one at your local drug store will remain slim until manufacturers find a way to lower their cost and make them more broadly affordable.
Electronic Health Records - Improving Patient Care Through Effective Communication
As the notion of “21st century pharmacy” continues to evolve, communication between pharmacists and other health care providers has become more important than ever. As you might guess, effective communication in health care requires diligent bookkeeping of patient files and medical information. One solution that has helped make this task easier and more efficient for health care professionals has been the invention and use of electronic health records (EHRs).
A major breakthrough in pharmaceutical care, EHRs allow the digital exchange of comprehensive patient profiles, enabling physicians, pharmacists and other members of patient’s treatment and care team to see and use the same version of a patient’s medical history. In a study of 72 Texas hospitals, the use of EHRs accounted for 15 percent fewer deaths and a 16 percent decrease in complications for patients suffering from various heart diseases and pneumonia.
Moreover, the use of EHRs has had a significant impact on reducing the amount of miscommunication that can occur between health care professionals. This innovative tool has enabled pharmacists to provide better care by keeping them more informed throughout the course of a patient’s illness and treatment. Indeed, better communication between health care professionals translates into higher quality of patient care.
Vaccine Patches - Making Prevention even more Painless
For many people, simply mentioning the word “vaccine” tends to bring up feelings of anxiety and fear, usually because many people fear the hypodermic needles traditionally used to administer them. Sometimes, patients have fear so extreme that it prevents them from keeping up with their recommended immunization schedules. Although it is possible to take some vaccines orally, most require injection, and until recently that meant using a hypodermic needle. However, one recent invention – the vaccine patch – may forever change the way we think of vaccines and the pain often associated with them.
The patch consists of 100 microscopic needles that pierce the skin upon contact and dissolve into bodily fluids, thus releasing the vaccine into an immune cell-rich area. Experiments have already proven the patch to be equally effective as traditional shots, and some scientists argue that further research will prove that patch vaccines can actually create an even better immune response than traditional shots, because the older method involves injection into muscle tissue, which does not contain a high density of immune cells.
Vaccine patches have the potential to completely revolutionize the health care delivery system; not only are they more patient-friendly, but they can also make immunizations more accessible, particularly for patients with limited health care (e.g., people who live in rural areas), because patches can be sold at pharmacies and self-administered by the patient himself or herself. Researchers also claim that the tiny needles on the patch are essentially painless and, more likely than not, will go unnoticed by the patient. The combination of these two factors make these vaccines seem less daunting for many patients, particularly children, eliminating both the pain associated with shots as well as a trip to the doctor’s office. Although the patch is not yet on the market, it is ready for clinical trials, and pharmacists estimate a cost similar to that of traditional needle-based vaccinations.
Did You Know?
During the Toronto SARS outbreak of 2003-2004, all medical workers, including pharmacists, had to wear head-to-toe protective gear including a face shield, double gowns, goggles, double gloves, a hood/cap, and shoe covers during procedures that carried a high risk for cross contamination. Needless to say, this made communication with patients harder.
Also during the Toronto SARS outbreak, special carts were created for use in hospitals for a “code blue” situation (signifying a heart attack). To help prevent the spread of germs, pharmacists added muscle relaxants to the drug trays on the carts to lessen the risk of patient movement during intubation (the insertion of a tube in the patient’s trachea to help them breath or to administer drugs).
The median expected salary for a pharmacist is $111,570 a year.
Different species of animals are used for testing new medications and products (mice, rats, rabbits and monkeys to name a few). Animal testing has helped make possible life-saving drug discoveries.
It can take up to twenty years to develop a new drug.