Evidence shows patient care improves with pharmacists' expanded roles: UAlberta and UMontreal research

Patients with asthma, diabetes, heart failure and hypertension see big benefits when physicians and pharmacists work together

Raquel Maurier - 19 August 2013

A medical professional fills out a prescription

Researchers at the University of Alberta and the Université de Montréal reviewed recent changes to pharmacy practice across the country and around the world, and found strong evidence that patients receive better care when pharmacists have expanded roles and are more involved in patient care.

In many areas of Canada and abroad, changes to the scope of practice for pharmacists has allowed them to renew and write prescriptions, adjust doses, change a prescription to a similar drug, give vaccinations and order and review lab work.

The research analysis was published in the peer-reviewed publication, the Canadian Medical Association Journal, today. Ross Tsuyuki, a pharmacist and professor with the Faculty of Medicine & Dentistry at the U of A, co-led the analysis with Cara Tannenbaum, a physician who works at the Faculty of Medicine and Faculty of Pharmacy at the Université de Montréal.

Their analysis examined the results of numerous randomized, clinical trials around the world that provided strong evidence that patients' health improved when pharmacists were more involved with patient care thanks to an expanded scope of practice. The trial results showed: patients' blood pressure and cholesterol levels were better, and patients with heart failure had 31 per cent lower rates of hospital admission. Other research has shown improvements for patients who have asthma and diabetes, and increased vaccination rates.

Tsuyuki and Tannenbaum noted more than 10 per cent of emergency room visits in Canada stem from drug-related problems, and elderly patients taking numerous medications who end up in emergency often have at least one drug interaction issue.

"Dealing with complex medication issues is their expertise, this is what pharmacists are trained to do, so expanding their role in this area makes sense and helps put patients first," says Tsuyuki. "People see their pharmacist more frequently than they see physicians. And some people don't have family doctors or can't get in to see a physician, so this expanded scope of practice for pharmacists benefits the public and could reduce the number of ER visits and hospitalizations.

"Alberta is a leader for expanding the breadth of scope of practice for pharmacists," says Tsuyuki, referring to changes which took effect in 2007, giving pharmacists in Alberta the broadest scope of practice in the country. "Here, pharmacists can do comprehensive medication assessments -- asking questions about what each drug is for, is it needed still, and to look for interactions. A patient could be put on a medication for an upset stomach, and 20 years later she is still taking the drug, and no one really remembers why. Pharmacists can help out in this area."

The researchers noted that with this expanded role, pharmacists and physicians need to ensure they communicate well about any changes to patients' medications. The article also noted that pharmacists' expanded roles can alleviate the high demand on physicians and allows them to work together as a health-care team to help patients.