Expanding pharmacists’ scope of practice cuts readmissions

A pharmacist consulting with a patient holding medication
Pharmacists can fill in some of the gaps left by the physician shortage. Image: Getty/Steve Debenport

The healthcare industry could tackle the physician shortage by expanding pharmacists' scope of practice, according to a new study.

Researchers at the University of Southern California developed a program to allow pharmacists to oversee transitional care, which was applied to about 1,100 high-risk Medicaid patients at Kern Health Systems in Bakersfield, California. The patients were discharged from Kern hospitals between April 2013 and March 2015 and into a pharmacist’s purview, according to the study, published in the American Journal of Managed Care.

For the first 30 days after discharge, pharmacists monitored patients to ensure that they followed medication guidelines correctly, scheduled follow-up appointments, arranged meetings with specialists and helped patients who needed transportation assistance. As as result, the program reduced 30-day readmission rates at Kern Health Systems by as much as 28% and reduced 180-day readmission rates by close to 32%, according to the study.

“This is the latest study to show that expanding the scope of practice for pharmacists could help patients and still save the health system money,” Jeff McCombs, an associate professor at the USC School of Pharmacy and the study’s corresponding author, said in an announcement.

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“The evidence is clear that community-based pharmacists can reduce health costs. The question is: Who will pay for expanding their role beyond dispensing medications at the counter?”

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The research from USC is not the first study to suggest that expanding the scope of practice for pharmacists may be a cost-effective solution to the ongoing physician shortage. The main stumbling block: Current federal law does not recognize pharmacists as providers, so implementing such a program would not be easy.

However, that could change. At least four states—California, Montana, New Mexico and North Carolina—have created an “advanced practice of pharmacy” designation, and Department of Health and Human Services Secretary Tom Price said during his confirmation hearings that he would consider expanding the role of pharmacists in patient care, according to the announcement.