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SUMMER 2017
SUMMER 2017
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Roger Paganelli, owner of
the Mt. Carmel Pharmacy
in the Bronx, remembers the
difficulties he faced when
juggling the six prescriptions he
took following knee
replacement surgery.
“I’m only 52, this (being a pharmacist)
is the only job I’ve ever had, and I found
myself saying, ‘Did I take that one?’”
says the third-generation pharmacist.
“I can certainly empathize with patients
who are elderly and take 20 to 25
prescriptions, two-thirds of which are in
tablet form.”
Patients on multiple medications
comprise a significant percentage of
the clientele seen by Paganelli and
other community pharmacists in the
Bronx. To support these patients in
managing their medications and their
overall health, the Bronx Partners for
Healthy Communities (BPHC), the
SBH-led Performance Provider System,
introduced a Community Pharmacy
Workgroup in February 2016. This
collaboration has led to several patient-
centered projects – the latest being the
evaluation of the use of antidepressants
and its effect on patients’ hemoglobin
A1C levels (which is indicative of a
three-month average of their blood
glucose level).
Additionally, this past May, a panel
discussion was held at SBH Health
System between members of BPHC’s
Program Advisory Committee (PAC)
and Bronx community practice
pharmacists. The focus was on how
these pharmacists can help improve
medication adherence.
PHARMACY NEWS
Making Community Pharmacists
Part of the Provider Team
Community pharmacists have become an increasingly essential part of the healthcare team
at hospitals like SBH.
By Steven Clark
PHARMACY NEWS
“Patients often return to the hospital or
come to the Emergency Department
due to undesirable events linked to
medication non-adherence, or their
inability to fill prescriptions at the
pharmacy,” says Ruth Cassidy, senior vice
president and chief pharmacy officer at
SBH. “Community pharmacists can play
a key role in helping to manage these
patients and need to be a component of
the provider equation.”
It was highlighted during the panel
discussion that there are myriad reasons
why many patients are not compliant
with their medications. These include a
lack of understanding why they need a
particular medication, confusion over
how to take it, an inability to pay for it,
a concern over side effects, or simply a
failure to get refills from the pharmacy.
Tony Sementilli, owner of Total Care
Pharmacy and a member of the
workgroup, says that patients can also be
afraid to ask their doctors questions, not
understand the answers, or only think of
questions once they leave their doctor’s
office. This is a role the community
practice pharmacist can play. “After all,
we are the last ones they see before they
go home and take their medications,”
Sementilli says.
Prior to this relationship with BPHC,
SBH and select community practice
pharmacies have been collaborating
on the “Meds to Beds” program. This
is where contracted pharmacies fill
medications to patients at the time of
hospital discharge. The program started
with a few nursing units in the hospital
and has been expanding due to its success.
“When patients get discharged and are
handed a bunch of prescriptions, the fill
rate is about 50 percent, and the chances
they will be readmitted are great,” says
Sementilli. “There is a lot of potential for
error. With Meds to Beds, they get 100
percent of what the physician wants them
to take once they leave the hospital.”
Community pharmacists also help
simplify the process for the patient and
health care worker in various ways,
such as by creating blister packs and
synchronizing medications (neither of
which they are reimbursed for). They
conduct medication reviews, don’t
require appointments and are available
virtually every day. “Those patients who
understand this, take advantage of it,”
says Paganelli.
Part of the transformation in health care,
say the community practice pharmacists,
will hopefully change the long-standing
perception of patients and providers
who view them merely as medication
dispensers. Not giving community practice
pharmacists access to patients’ electronic
medical records – hospital pharmacists
have access to this information – only
furthers that perception. To fully
understand what’s going on with the
patient, having such access is imperative,
say the community pharmacists.
“When you go to a pharmacy, your
question is often, ‘Why does it take
so long to fill 30 pills?’ or ‘Why am I
spending so much money for an inhaler?”
says Cassidy. “In New York and other
states, patients, providers and insurers
have to look at community practice
pharmacists as part of the medical team.”
“When patients get
discharged and are handed
a bunch of prescriptions,
the fill rate is about 50
percent, and the chances
they will be readmitted
are great.”
