Pharmacist involvement in patient rheumatology care is growing. This care is enhanced, in part, thanks to the advocacy and contribution from Concordia University Wisconsin’s School of Pharmacy faculty member Dr. Nick Zupec.
Zupec sits on the American College of Rheumatology Training and Workforce Issues Committee and strongly supports pharmacist-to-patient rheumatology medication management. Not only does this lead to greater patient care, but there are also new rheumatology medications available. Zupec feels it is an especially exciting field for pharmacists because many rheumatology-based diseases have been largely untreatable. Now that’s changing.
“There have been patients for a long time who haven’t been able to control their pain,” Zupec said. “There’s been an explosion of new medications for rheumatology care and this is an exciting time for pharmacists and their importance in rheumatology.”
This fall Zupec was appointed to the committee which is related to workforce and training. Zupec is the only pharmacist on the national committee and he will serve the next three years advocating for interprofessional pharmacy involvement in rheumatology. This involves including pharmacists, nurses, and other health care roles in rheumatology care.
An Interdisciplinary Medical Team Approach
Medical professionals have long worked together to provide patient care across the medical field. But for rheumatology in particular, the complex and often times challenging array of rheumatic diseases and medications makes interdisciplinary care important. Rheumatology care involves medical professionals from across the field to manage pain, medication, patient relationships, and more. The role of the pharmacist, in particular, is growing. According to a 2017 ACR abstract:
“The addition of a pharmacist to the healthcare team can have many benefits, including improving patient compliance and education, serving as a drug information resource, and obtaining insurance coverage. This includes establishing patient relationships, gathering medication histories, preventing, identifying and resolving medication related problems, educating patients and other healthcare providers, monitoring patients and medication effects, and contributing to continuity of care for all patients. “
Zupec recognizes this importance and is creating innovative ways for pharmacists to make a difference.
“By 2030, there is going to be a big need in rheumatology,” Zupec said. “I see patients independently at the hospital now, and the growing question is how we as a medical team can do things differently. Perhaps with a pharmacist working one on one with the patient on rheumatology medication education frees up physicians to do different things. I’m excited to provide a pharmacist’s perspective to see how we can help solve this problem.”
Importance of the Pharmacist Expertise
One main role of a pharmacist is reviewing a patient’s medication experience, listening to how the medication is working or not working, and then monitoring and improving their medication experience. Pharmacists help patients understand the benefits of taking medication, when and how, and understand the science and “why” behind the treatment plan. Many rheumatology patients are dealing with complex medications that may bring different side effects affecting daily life. Introducing a new rheumatology medication may alter another medication’s effectiveness. There is a lot of information for a patient to balance, but a pharmacist helps make the experience manageable.
“A pharmacist consultation can be the difference between a patient having a bad medication experience versus a potentially life-changing benefit,” Zupec said.
One example of a pharmacist’s increased role is to lead more medication consultant visits. These visits are one-hour appointments for pharmacists to meet directly with patients. During these meetings, conversations focus on medication management and side effects.
“We not only help patients understand the benefits of a medication, but we can also review the page-long list of side effects and work together to work out a plan that will work for the patient,” Zupec said. “Then we help them come up with strategies and reminders to take it.”
Some simple suggestions Zupec offers include setting an alarm on your phone, taking medication with coffee or a daily habit, using a pill box, or putting medication on a nightstand to remember to take before bed, so long as the medication is out of reach from small children.
In addition, another example of interdisciplinary work in rheumatology is collaborative care. With collaborative practice agreements, a physician and pharmacist can agree to work together on patient medication management. Through such agreements, pharmacists have the authority to check labs, check doses, and adjust medications based on a patient’s needs. This experience not only gives the pharmacist the ability to implement changes that reflect pharmacy training but also frees up physicians to focus on other tasks.
Zupec’s Involvement in Rheumatology and the Committee Moving Forward
The American College of Rheumatology is a professional national organization with over 30 health professionals including nurses, pharmacists, doctors, and more. It is rare pharmacists are on this committee, but the American College of Rheumatology (ACR) recognizes the need for a pharmacist’s perspective. In 2017, an ACR abstract noted: “Rheumatology healthcare providers recognize the burden of rheumatic disease requires an integrated, multidisciplinary team including a pharmacist.”
Zupec meets across the country three times a year with health professionals including nurses, doctors, and other medical professionals. Zupec’s involvement speaks to the importance of involving pharmacists in rheumatology care.
“A pharmacist consultation can be the difference between a patient having a bad medication experience versus a potentially life-changing benefit,” Zupec said.
“It’s important that they have a couple non-physicians on the committee, which doesn’t traditionally have a pharmacist on it, to give another important perspective,” Zupec said.
Zupec brings his research and involvement with the committee back to students at Concordia University.
“The committee focuses on training and education which is what I do here at Concordia,” Zupec said. “This aligns with training students perfectly.”
He also plans to stay involved with rheumatology advancement.
“Pharmacy is just starting to grow in rheumatology. In the last 5 years especially there’s been an insurgence of pharmacy involvement,” Zupec said. “We’re hoping that going forward there would be more opportunities for pharmacists to get involved. I feel like this is the next big thing in pharmacy.”
To learn more about pharmacy at Concordia, visit the School of Pharmacy’s website.
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