Polypharmacy II: How a Clinical Pharmacist Team Helps Manage Medications

Note: This is part 2 of Reliance Medical Centers series on Polypharmacy. To read part 1, click here. 

What is Polypharmacy? Polypharmacy is the use of many drugs by a single patient or multiple drugs for a single condition, which by design increases the chances for adverse medical outcomes.

A Clinical Pharmacist plays an important role in decreasing polypharmacy in the  Primary Care setting. Clinical Pharmacists consult with patients and the patients’ Primary Care Physician to help evaluate medications and prescribe the best treatment plan. In this article, we are looking at all the ways Clinical Pharmacist Teams can help improve a patient’s medication routine and as a result, overall health, quality of life and the way a patient feels. 

What is a Clinical Pharmacist?

A Clinical Pharmacist is a pharmacist who, according to the American College of Clinical Pharmacy, “works directly with physicians, other health professionals and patients to ensure that the medications prescribed for patients contribute to the best possible health outcomes.” A Clinical Pharmacist also contributes to care coordination in a Primary Care setting by advising physicians about appropriate medications and potential side effects of different prescriptions. 

At Reliance Medical Centers, a Clinical Pharmacist works as part of your Primary Care Team to provide comprehensive education, consultation and counseling that extends beyond what a pharmacist at a retail pharmacy provides. Personalized care and treatment plans are crucial for patients who experience polypharmacy. Here are some of the ways a Clinical Pharmacist helps manage polypharmacy. 

Education About Medication Interactions

A Clinical Pharmacist meets with patients to review how all their medications interact, not just their prescription medications. One common example is the interaction between Warfarin, a prescription blood thinner, and ibuprofen, a common over-the-counter pain reliever. When taken together, these medications increase the risk of internal bleeding. 

“Since ibuprofen does not need a prescription, people assume that it is safe to take with all their prescriptions. One of the things I counsel a lot of my patients about is how to safely take over-the-counter medications alongside their prescriptions,” said Dr. Adriana Hughes, Clinical Pharmacist Program Manager at Reliance Medical Centers. “Educating patients on side-effects and interactions improves overall health, which can reduce the need for certain prescription medications.”

Alternative, Non-Medicated Solutions

A Clinical Pharmacist can help patients find the best remedy for their health needs. Sometimes, the solution is not a prescription, but a non-medicated approach. Depending on the patient’s medical history and the current number of prescription medications they are on, a Provider or Clinical Pharmacist may recommend prescribed medical massage therapy for arthritis or pain relief. Another example is a meeting with a Wellbeing Advisor (LCSW) to discuss feelings of anxiety, stress, isolation or depression. While a Clinical Pharmacist does not recommend these things as a replacement for a prescription, for many people these approaches are more beneficial than a medicated solution.

Review Medication Regimes

Prescription medications should be regularly reviewed and updated to ensure that they are safe, effective and cost-effective. Changes in health, other prescriptions and other health factors may cause a once effective prescription to become ineffective or no longer needed. Even worse, it can become dangerous for the patient to continue on this regime. Because of this, Clinical Pharmacists and Primary Care Providers work closely together to review and update patients’ medications. Sometimes these reviews can lead to deprescribing, where a patient either reduces or discontinues a prescription. 

Deprescribing is done only when it is in the best interest of the patient. People who experience polypharmacy are at a greater risk of negative side effects, drug interactions and hospital admissions. Deprescribing helps reduce these complications by making sure all medications are both necessary and safe. 

“As a Primary Care Doctor, my number one concern is patient health. I see patients who have been taking a prescription for years, far past when they should have stopped,” said Dr. Carlos Romero, Co-Founder, Co-CEO and Chief Medical Officer at Reliance Medical Centers. “Reducing polypharmacy is one of the reasons Reliance started the Senior-Focused Clinical Pharmacy Program. Medication should always be working to improve health and anytime it is not helping, we look to fix the problem to ensure best health outcomes.” 

Reliance Medical Centers has been creating solutions for patients since its inception in 2017 and a no-cost consultation with an in-house Clinical Pharmacist is a great addition to routine Primary Care. To learn more about the Clinical Pharmacist Team, click here. 

Sources

American College of Clinical Pharmacy

National Library of Medicine: Deprescribing

National Library of Medicine: Polypharmacy 

National Library of Medicine: Risk Factors of Warfarin