Where Do Pharmacists Add Value in Arrhythmia Care? Lindsey Valenzuela, PharmD

When pharmacists practice in value-based care settings, their impact on arrhythmia management expands far beyond medication dispensing, according to Lindsey Valenzuela, PharmD, APh, BCACP, vice president of population health integration at Desert Oasis Healthcare.

Valenzuela told The American Journal of Managed Care® (AJMC®) that pharmacist-run clinics and team-based medication management can reduce errors, close care gaps, and improve patient satisfaction. She stressed that this is extra beneficial to women managing multiple health conditions and caregiving responsibilities.

This transcript has been lightly edited; captions were auto-generated.

Transcript

Where do you see pharmacists adding the most value in arrhythmia management for women, especially when addressing medication adherence, anticoagulation safety, or transitions of care?

I really think value-based care environments are the perfect opportunity for pharmacists. Our organization has existed in full risk capitation value-based care for 45 years, and this sort of risk payment model allows the organization to make decisions on how they use their reimbursement to support their patients.

Our organization has decided that clinical pharmacists managing chronic diseases, independent of the physicians but in collaboration with them, makes a lot of sense for reducing costs, things like ER [emergency room] and acute care utilizations, improvement in outcomes, improvement in quality measures, and also patient satisfaction.

You mentioned anticoagulation safety—that was our first clinic that we started 20 years ago. Physicians were very comfortable with us managing anticoagulation, but really it was the first opportunity for us to contain all of the risks of medications in 1 clinic. And since that time, our pharmacists have moved on to managing cardiometabolic disorders, pulmonary diseases like COPD [chronic obstructive pulmonary disease] and asthma, managing poststroke heart failure, AFib [atrial fibrillation]. And what you notice about all of these is they all overlap.

When you have amazing pharmacists in your team who can manage multiple layers of these disease states—they have diabetes, but they also have had a stroke, and they've got AFib—you can have a single pharmacist who's really helping to manage those disease states. The patient is talking to 1 person; the physician is familiar with 1 person. You're really getting somebody looking at that holistic medication view, and it reduces the risks of errors. And it also allows for greater transition of care.

While we don't want patients to be using the hospital, we know that when that happens, the pharmacist can take in the information from what happened in the hospital, knowing what happened on the outpatient before they got there, and make sure that the transition of care is safe, the patient is aware of changes, the primary care is aware and sharing that information. And we know that a lot of these errors impact women more than they impact other parts of the population.

Women are afflicted with numerous factors in our society that may not impact men; they're more likely to forgo care to provide care for their family; they're often providing care for their own children while also providing caregiving for their aging parents. And I think pharmacists in these areas are able to provide an elongated dialogue with women to really understand those barriers, because if you understand the barriers why somebody may not be accessing care or it may not be easy for them, you can provide answers. Those might be financial pressures or those social limitations.

We can provide that advocacy within the health care system. And we actually provide our pharmacist services completely for free, which you can do in a value-based system when you've decided that the outcome from providing these services is so great that we don't want cost to be a barrier to anybody using those services.

Value-based [care] gives pharmacists really an opportunity to practice at the top of their license in a myriad of different disease states to support the health care team. And, in value-based care, you can do it in a way that makes it available to the entire population, not just women, not just different racial groups or socioeconomic groups, but everyone.