To keep Ohioans healthy, pharmacists can play a bigger role

The woman, a resident of rural southeast Ohio, had just received prescriptions for drugs to treat anxiety and depression. Her doctor hadn’t explained much, the woman told her pharmacist — these were simply the drugs she had used in the past. She was near tears as she described her anxiety; she wouldn’t be seeing her doctor again for at least six weeks.

The pharmacist asked the woman questions, part of two tests designed to determine the seriousness of a patient’s anxiety and depression. He explained the most effective way to restart the medications, he reassured her treatment was necessary, that he would communicate with her doctor about their discussion, and he made plans to personally follow-up with before she would see her doctor again.

In the ongoing battle to gain ground against chronic health problems that make life harder for the most vulnerable Ohioans, a familiar fixture — the neighborhood pharmacist — is emerging as a powerful ally.

Innovative and smart programs enabling pharmacists to play a larger role in their patients’ care hold the promise of better control of diabetes, asthma, depression, anxiety, and other costly and debilitating chronic conditions. They’re made possible in Ohio by a law change that expanded the types of care for which pharmacists can be paid, and early results indicate it is working.

Scenes like the one described above are happening around the state, thanks to programs developed by Ohio’s Medicaid Managed Care plans and partnering pharmacies. Patients are receiving time and individual attention. That translates to better understanding of their conditions and how to take their medications properly and monitor their health.

That, in turn, means better health outcomes and quality of life for patients and lower costs for taxpayer-funded Medicaid.

The southeast Ohio pharmacist works for Shrivers Pharmacy, an independent group of eight pharmacies participating in an early program developed by Molina Healthcare. Ten pharmacy companies are participating because they serve high numbers of Molina members and are in areas with poor access to primary care providers.

In the program, pharmacists choose a condition on which to focus and reach out to affected patients, offering education and extra counseling. Recent Medicaid rule changes allow Molina to pay the pharmacists to engage with these patients, making it feasible for pharmacists to spend the time and provide the private space.

Andrea Kowalski, Shrivers’ director of clinical services, chose behavioral health because of the uptick in prescriptions for anxiety and anti-anxiety medications the company observed as the COVID-19 pandemic wore on.

Early results are promising. For one thing, patients given extra counseling are universally grateful, Kowalski said. And pharmacists are gratified to be recognized and encouraged to use their full range of skills and knowledge. Said Kowalski, “They’re telling me, ‘This is what I went to school for.’”

Best of all, of those depression and anxiety cases in which a pharmacist intervened, 73% showed improvement or were stable on follow-up assessments within two months. And for those whose conditions worsened, their pharmacists were aware and prepared to discuss with their primary care provider to intervene further.

The rush of COVID-19 patients inhibited the ability of pharmacies to fully implement the  program since it began last October, but Molina expects to see the numbers grow. Shrivers is beginning a separate project in which pharmacists will help Molina patients control their diabetes. More data will help make the case for extended care by pharmacists.

Said Kowalski, “We know that we can have an impact on our patients, but it’s hard to show that if we don’t have hard data and numbers. We’ve done this sort of work for a long time; now that we can get paid, we can sustain that model and develop even more complex and specialized services to help our patients be healthier.”

I’m confident that Ohio’s pharmacists can and should play a larger role in keeping Ohioans healthy.