Report of the 2009-2010 Professional Affairs Committee: Pharmacist Integration in Primary Care and the Role of Academic Pharmacy

According to the Bylaws of the AACP, the Professional Affairs Committee is to study: issues associated with professional practice as they relate to pharmaceutical education, and to establish and improve working relationships with all other organizations in the field of health affairs. The Committee is also encouraged to address related agenda items relevant to its Bylaws charge and to identify issues for consideration by subsequent committees, task forces, commissions, or other groups. COMMITTEE CHARGE President Jeffrey Baldwin charged the 2009-10 American Association of Colleges of Pharmacy (AACP) Standing Committees to consider the role of the pharmacist in primary healthcare and identify the public policy, workforce, education and advocacy issues associated with advancing pharmacists' contributions to systems of primary care. The Argus Commission, Advocacy and Professional Affairs standing committees focused on the pharmacist's role in primary care. How will/do pharmacists integrate their unique expertise as medication use specialists into primary care delivery to improve patients' lives? Their work is grounded in the Institute of Medicine definition for primary care and the Joint Commission of Pharmacy Practitioners (JCPP) Vision Statement for Pharmacy Practice 2015: * "Primary care is the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients, and practicing in the context of family and community;" (1) * "Pharmacists will be the healthcare professionals responsible for providing patient care that ensures optimal medication therapy outcomes," (2) Specifically, the 2009-10 Professional Affairs Committee is charged to: * Examine the evidence for pharmacists' integration in primary care practice in the community in the context of partnership with patients and healthcare service providers. * Provide analysis of current and potential care delivery models. BACKGROUND Healthcare reform is a topic at the forefront of concern for Congress, the public and healthcare professionals. The primary care workforce is comprised of a diverse complement of health professionals with direct patient care provided by allopathic and osteopathic physicians, nurse practitioners, physician assistants, and registered nurses. Pharmacists are among the health professionals with growing responsibilities in the provision of patient care services within the primary care environment. (3) Others include social workers, medical assistants, and nutritionists. An adequate supply of all healthcare professionals will be required to meet the future demand for services and many recent publications reflect a growing concern for the workforce supply fulfilling this demand. (4) It is important that pharmacists are considered in legislation related to the future of the health professions workforce and future healthcare policy. To determine how pharmacists may influence healthcare reform, a critical review of the evidence of pharmacists' involvement in primary care service delivery is necessary. In the early 1990s, the concept of pharmaceutical care emerged and took hold. (5) Healthcare reform, as pressing then as it is now, embraced pharmacists offering pharmaceutical care as the most vital contribution pharmacists could make in primary care to produce positive patient outcomes. Providing pharmaceutical care meant that pharmacists should enter into a partnership with patients, be accountable for drug therapy outcomes along with other healthcare providers, manage drug therapy, and coordinate the "continuum of drug therapy." (6) Several barriers to providing pharmaceutical care were identified, including lack of continuity between institutional and community pharmacy practice settings, lack of technology allowing pharmacists to take a greater responsibility for drug therapy outcomes and the lack of reimbursement for provision of pharmaceutical care. …