American College of Clinical Pharmacy
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ACCP Report - July 2019

Clinical Pharmacy Practice in the Community Setting – First Themed Issue of JACCP

Written by Jerry L. Bauman, Pharm.D., FCCP
Editor-in-Chief, JACCP



Journal of the American College of Clinical Pharmacy

In December 2016, the Chicago Tribune published an initial article1 (followed by a series) of an investigative report showing that pharmacists in community pharmacies (chains and independents) throughout the Chicago area missed most (52%) serious drug interactions when confronted with (fake) prescriptions. Although I was not incredibly surprised, I was incredibly disappointed. The facts brought out by this article caused quite a stir, prompting legislators to become involved, a statewide task force to be formed (on which I am currently serving), and me to develop an interest in clinical pharmacy services in the community setting. Surprising to me, I found very little in the literature regarding drug safety and medication errors in community pharmacies and the role of the pharmacist, clinical or otherwise. However, I did come to the realization that the practice model currently in place in most of these settings requires a complete re-boot. My interest in drug safety and medication errors in community pharmacies and the pharmacist’s role also led indirectly to choosing the focus of the first themed issue for JACCP, scheduled for August 2019.

Melissa McGivney from the University of Pittsburgh College of Pharmacy was chosen as the guest editor of this issue because of her expertise in this area and her enthusiasm and optimism that change will occur. Apparently, I am not the only one interested in this topic: we received more than 100 inquiries about potential papers, and ultimately, 38 papers (including two editorials) were considered. Clinical pharmacy services in community pharmacies must overcome some barriers that are not present in the hospital setting, and as such, change in this area will require pioneers with resilience and persistence, not unlike during the early days of the clinical pharmacy movement that emerged mainly in hospital settings. Almost all of the papers we received came from clinical faculty in academic institutions, and, in thinking about it, it is logical that these pioneers would arise from colleges of pharmacy. Most colleges in the past decade have invested in clinical pharmacy faculty who are asked to develop practice in a community pharmacy – where most graduates end up. Of importance, colleges have partnered with community pharmacies to develop residency training programs that create a pipeline of young thought leaders and “change agents” going forward. Where once community pharmacy residencies were novel and uncommon, most colleges of pharmacy now more than likely have several.

To overcome the present barriers and push the boundaries of clinical practice in community settings, corporate, publicly traded pharmacy entities and payers will need convincing. Among other things, methodologically sound research that demonstrates new practice and payment models leading to improved health outcomes and is cost-effective is needed. By far, most of the inquiries we received and the papers we reviewed were for the journal’s section on “Clinical Pharmacy Research Reports,” but only seven were ultimately accepted for the issue. Many of the papers submitted or suggested were pilot studies, small demonstration projects, or projects with only preliminary data. Although it is good and necessary that these projects are beginning, more impactful research is needed. That’s where ACCP member leadership can play a major role – we need research. Many of the studies in the pilot phase seemed novel and promising; I asked the authors to consider submitting their work to JACCP, once completed. JACCP is devoted to all things clinical pharmacy practice, and clinical pharmacy is clinical pharmacy wherever it is practiced.

References

  1. Roe S, Long R, King K. Pharmacies miss half of dangerous drug combinations. Chicago Tribune. Available at www.chicagotribune.com/news/watchdog/druginteractions/ct-drug-interactions-pharmacy-met-20161214-story.html. Accessed April 23, 2019.