1. www.pharmacist.com JULY 2015 • PharmacyToday 73
PHARMACISTSPROVIDECARE.COM
‘Going over the whole list’:
Pharmacist consults can save lives
sonya collins
When Hayam Mowgood, PharmD, called “David” to see how
he was doing on his new prescription, David thought he was
doing fine.
“He said he didn’t have any ques-
tions or concerns, and that there were
just a few [adverse] effects,” Mowgood
recalled.Whathecalled“adverseeffects”
were a rash and
tongue swelling
that caused him
to choke when
he ate.
Mowgood ex-
plained to the
patient that this
was an allergic
reaction, not ad-
verse effects. She
instructed David
to wait while she
called his doctor. The doctor saw David
immediately, gave him an epineph-
rine pen for the allergic reaction, and
changed his medication.
“He wouldn’t have reported this
reaction if I hadn’t called him. It
could have been life-threatening,”
said Mowgood, a clinical pharmacist
at a Ralphs Pharmacy in Placentia,
CA. Mowgood provides consults to
patients monthly on all their medica-
tions, screening for allergic reactions,
adverse effects, interactions with other
drugs, and proper usage. She has
helped many patients avoid close calls
like this one.
Life-saving consultations
In California, pharmacists are now
recognized as health care providers
(see page 72 for more information on
SB 493). But unlike doctors, nurses,
physician assistants, and most other
health professionals, pharmacists for
the most part still can’t bill insurance
for the services they provide—includ-
ing often life-saving consultations to
ensure that patients are taking their
medications properly and without
risky results.
“Medication therapy management
works so well because I’m not doing
a consultation on a single medica-
tion. I’m going over the whole list and
checking for any possible problems,”
Mowgood said.
Many Americans could benefit
from the services Mowgood and other
pharmacists provide. More than 90%
of noninstitutionalized older adults
take prescription medications, accord-
ing to Annals of Family Medicine. At
least one in four has multiple chronic
diseases.
Pharmacists are accessible
Americansoftenseeadifferentdoctor
for each condition. Each doctor pre-
scribes the medications that pertain
to that condition, sometimes without
recognition of the other drugs the
patient may be taking. When patients
have an allergic reaction to a medica-
tion, an adverse effect, or symptoms
of one drug interacting with another,
they may see yet another doctor—in
the emergency department.
About 15% of older adults who
visit hospitals, doctor’s offices, or
extended care facilities are having
adverse drug events.
These events could be avoided
with regular consultations with a
pharmacist. “Pharmacists’ skills go
well beyond just dispensing medica-
tions,” Mowgood said. “We have the
education to provide this care.”
In her visits and calls with patients,
Mowgood has identified numerous
drug reactions.
One patient’s hands, feet, and
ankles were swelling when he came
in—a common adverse effect from
blood pressure medication.
A patient taking budesonide/for-
moterol fumarate dehydrate (Symbi-
cort—AstraZeneca) for his chronic
obstructive pulmonary disease men-
tioned to Mowgood that his atrial
fibrillation was getting worse—an
adverse effect of the drug in people
who have the heart condition.
Another patient reported hearing
loss to Mowgood with neomycin.
None of these patients thought
their symptoms were significant
enough to report them to their doc-
tor. They mentioned the symptoms
to Mowgood only because she asked.
Without the pharmacist consult, they
might never have made the connec-
tion between the drugs and their
symptoms. And their conditions
might have gotten worse.
“Some patients have to wait months
to see their primary care providers,”
Mowgood said. “In the meantime,
pharmacists are available and able
to manage medications [and] chronic
diseases, and provide prevention and
wellness.”
Sonya Collins, MA, MFA, contributing
writer
hubonproviderstatus
Provider status stories
Pharmacists are health care providers. In a series of profiles appearing in Phar-
macy Today and on pharmacist.com, pharmacists explain how their patients would
benefit from provider status. And as part of our campaign for provider status, APhA
has asked pharmacists to share their story of how they provide care to their patients
and how provider status will improve health care. These stories are collected on the
APhA YouTube channel at https://www.youtube.com/user/aphapharmacists/playl-
ists. If you would like to share your story, please visit PharmacistsProvideCare.com.
“He wouldn’t have reported this reaction if I hadn’t
called him. It could have been life-threatening.”
Hayam Mowgood