The Pharmacist’s Role in Managing Rheumatic Diseases

Rheumatic disease treatment requires an integrated, multidisciplinary team. Adding a pharmacist to the team has many benefits, including improving patient compliance and education, providing a drug information resource, and assisting in assuring insurance coverage. The role of a pharmacist can vary greatly depending on the practice setting, but ultimately, pharmacists play a key role in supporting pharmaceutical care. This includes establishing patient relationships; obtaining medication history information; preventing, identifying, and resolving medication-related problems; dispensing medications; educating and counseling patients and healthcare providers; monitoring patient and medication effects; and ensuring continuity of care.

Where Does the Pharmacist Work?

A pharmacist may work in a variety of settings. These include a community pharmacy such as an independent or chain drugstore, a hospital pharmacy, or ambulatory-care settings such as an outpatient hospital clinic or private medical practice.

In the community pharmacy, the pharmacist is primarily responsible for counseling patients on new medications, properly filling a medication order from a prescriber, and answering questions that may arise from other healthcare providers or patients. A community pharmacist is likely the first person a patient calls to ask a question about a medication because of this professional’s easy accessibility.

Pharmacists who work in a hospital setting play a role in dispensing medications, verifying and clarifying medication orders, and mixing medications. Pharmacists in hospitals may also have a role in medication reconciliation, discharge counseling (particularly newly diagnosed patients or those starting a new medication), and working with physicians and nurses to provide direct patient care. Pharmacists may also participate in physicians’ rounds to provide suggestions on treatment options for patients with rheumatic diseases. This may be most helpful when providers are treating patients with refractory diseases, as the pharmacist may serve as a valuable drug information resource.

A pharmacist who works in the ambulatory-care setting may have many different responsibilities. The pharmacist may see patients in the office for educational counseling sessions, talk with patients about their specific drug questions, or work with providers to serve as a drug information resource.

The entry-level educational requirement for pharmacists is now a doctoral degree. Some pharmacists also go on to complete one to two years of residency training, with the majority of these pharmacists going into hospital or ambulatory-care pharmacy settings. Although there are second-year, postgraduate specialty training programs in pediatrics, oncology, infectious disease, cardiology, critical care, emergency medicine, and internal medicine, currently there are no specialty trained rheumatology programs for pharmacists. The number of residency-trained pharmacists continues to grow, although residency training is currently not mandatory for all pharmacists.1

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