The Role of Pharmacy: Past, Present and Future

By Kindred Healthcare

Did you know that a pharmacist invented Coca Cola? This was just one interesting fact divulged by Kindred Hospital Division Vice President of Pharmacy James Poullard, who presented this afternoon at Kindred’s Fifth Annual Clinical Impact Symposium.

For Coke lovers, this fact makes pharmacists critical. But more importantly, pharmacists play a crucial role in effective care transitions.

Pharmacy – the science and technique of preparing and dispensing drugs and medicines – has undergone a transformation over the years, according to Poullard.

“We’ve gone from pouring sodas and mixing elixirs to now being the medication expert in retail outlets, and in the inpatient arena,” he said. “There are now post-graduate residency programs and we’ve become an integral part of the patient care team.”

And pharmacists have their work cut out for them.

 James Poullard, Vice President of Pharmacy, Hospital Division James Poullard, Vice President of Pharmacy, Hospital Division

Low health literacy, multi-morbidity with associated polypharmacy and the increasing age of patients are sources of some of the issues related to poor medication adherence. Poor hand-off communication is another.

According to Poullard, 67 percent of acute care hospital admissions are characterized by medication discrepancies, with varying clinical significance, and those discrepancies continue through discharge.

Medication-related problems cost the healthcare system billions. And they affect quality of life; when people are sick and not taking their medications properly to feel better, their quality of life goes down.

With the Affordable Care Act, there has been a renewed focus on pharmacy’s role in effective care transitions, with the goal of preventing avoidable hospital readmissions.

Statistics show that 14 percent of hospital readmissions are due to medication-related problems in elderly patients.

Kindred is well-positioned to address this problem because we operate in the post-acute space, said Poullard, and pilot projects in Boston and Indianapolis are doing just that.

He said that Kindred clinicians and staff could begin by identifying transitional care pharmacy practice opportunities within Kindred, such as:

  • pharmacist-led medication reconciliation for after-hours admissions (currently a best practice but not standard practice)
  • on average, two medication-related problems per referral are identified on discharge medication reviews requested by the care transitions managers
  • missed opportunities occur during a transitional care hospital stay to address clinically significant medication issues that likely will evolve in the outpatient setting

Finally, Poullard said, hand-off tools are evolving but in the meantime, the phone is an old-fashioned tool that can be used to communicate important care transitions information. Pharmacists may have moved beyond inventing tasty soda products, but in some cases, old-fashioned may still be very relevant.

James Poullard, Vice President of Pharmacy, Hospital Division

By Kindred Healthcare