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The Pharmacist’s Role in Managing Rheumatic Diseases

Carissa Flick, PharmD, and Jessica Farrell, PharmD  |  Issue: August 2013  |  August 1, 2013

Drug-information resource: Providers spend many hours a day seeing and helping patients. This time constraint makes it difficult to analyze the literature for the prevalence of a rare side effect, or know what drugs may be safely used during pregnancy or lactation. Utilizing a pharmacist allows this to be done in depth. Pharmacists are able to evaluate the literature and summarize it for the provider. A pharmacist can also document drug information in the medical record with proper references, or contact the patient directly to answer a medication-related question. This involvement is likely to improve patient communication with the rheumatology team and assure the patient that he or she is receiving optimal care. Adding a pharmacist to any practice setting will give the provider more time to spend with patients without sacrificing quality.

In addition to being a behind-the-scenes drug-information resource, a pharmacist is a medication expert. They dispense education to providers on new medications, pertinent drug interactions, or other important drug topics. Depending on your practice site, a pharmacist can offer this information formally during weekly educational conferences or informally on an as-needed basis. Pharmacists assist providers when picking an appropriate therapy regimen for a patient. A pharmacist brings a different perspective and may be able to provide unique insight when choosing the right medication for a patient.

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Prior authorization insurance letters: A growing number of published reports suggest that various biologics predominantly approved for RA can be efficacious treatment options for several rare rheumatic diseases.6 Unfortunately, many practicing rheumatologists are hindered in their ability to employ these potentially effective treatments for their patients because of difficulty in obtaining coverage from insurers. In most instances, insurers deny coverage of off-label use because no double-blind, placebo-controlled studies have shown that the agent is effective for the disease being treated. As practicing rheumatologists know, this type of evidence is only infrequently available for these rare rheumatic diseases. For many of these conditions, there may not even be a single agent approved by the U.S. Food and Drug Administration to treat the disease due to its rarity. Consequently, the medical director for the insurer may not be aware of these facts or have any familiarity with the disease. The potential consequences of nontreatment, or the inadequacy of other accessible therapies, can be devastating to the patient’s care.

Pharmacists are able to analyze the literature that supports the off-label use of a medication, and summarize it in a letter that includes patient-specific characteristics and history, to prove the benefit of the medication. This is an important service, particularly because cost is often a burden for patients and can decrease compliance.

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Filed under:From the CollegePractice Support Tagged with:patient carepharmacistPractice ManagementRheumatic Disease

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