Advantages of Embedding a Specialty Pharmacist in a Rheumatology Clinic

Overcome the Barriers

Pharmacists trying to get involved in rheumatology practice do face barriers. Notably, pharmacists are not recognized as providers under Medicare Part B, which limits their ability to be reimbursed for clinical services rendered.¹⁵ States vary in their laws regulating the activities of pharmacists.

Pharmacists often have collaborative practice agreements with other practitioners that outline what they can do.¹⁶ Under collaborative practice agreements, qualified pharmacists under defined protocols may be able to perform patient assessments, provide counseling, order laboratory tests, administer drugs and titrate medications. Two useful examples are with methotrexate and urate-lowering agents.

Another barrier is having enough exam rooms for the pharmacist to meet privately with patients. The advent of telemedicine and follow-up phone calls may assist with this process.

An additional challenge is having practitioners recognize how pharmacists can benefit the practice and accept and welcome the pharmacists’ expanded role.

Adding a specialty pharmacist to a multidisciplinary rheumatology practice is one option to improve medication safety, decrease delays to medication access, increase adherence, increase revenue and improve quality measures.^10,12,17 It can allow rheumatologists more time to focus on different areas of their practice.

There is a need for further study to demonstrate and document improved patient care and time and cost savings.

Polly J. Ferguson, MD, is the Margorie K. Lamb Professor, and director of Pediatric Rheumatology, Immunology and Allergy at the University of Iowa, Carver College of Medicine, Iowa City.

Jessica Lynton, PharmD, BCPS, is a clinical pharmacy specialist–pediatric rheumatology for Specialty Pharmacy Services at the University of Iowa.

Beth H. Resman-Targoff, PharmD, FCCP, is a clinical professor in the Department of Pharmacy: Clinical and Administrative Sciences at the University of Oklahoma College of Pharmacy.

References

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