The case for pharmacist involvement in patient health management.
• In the U.K. it is estimated that 60 percent of hospital bed days are devoted to chronic disease and related complications. The U.K has developed a number of strategies to meet the challenges of the rising prevalence of chronic disease including an emphasis on self-management and a strong effort to improve medicines use.
• In the U.S. 88 percent of Medicare spending is consumed by patients with three or more chronic conditions.
• The U.K Department of Health estimates that 50 percent of patients fail to take their medicines properly and has initiated a number of self-care projects such as the Expert Patients Programme and the Medicines Management Programme.
• According to a U.K Department of Health discussion document, "an intrinsic chronic disease management equation is that increased investment in pharmaceutical care offsets hospitalization and medical procedure costs."
• A U.S. study of a community-based disease management service showed substantial reductions in healthcare costs in patients with hypertension, hypercholesterolemia, diabetes and asthma.
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Chronic Disease Management and Community Pharmacy: Threats and Opportunities
- More status for the pharmacy profession, as effort to improve medicines use is a central component of CDM
- Financial logic of CDM is one of increasing investment in pharmaceutical care, offsetting medical procedure costs
- Emphasis on self-management matches community pharmacy outlook
- Pharmacy repeat dispensing will provide a platform for chronic disease interventions, and other Vision for Pharmacy developments, such as supplementary prescribing, also open the way for pharmacy input
- Lost opportunity if community pharmacy fails to define its unique contribution or marshal its evidence base, thereby being left out of policy development, generic modeling and care pathways
- Diminished status for the profession (and long-term narrowing of the vision for pharmacy) if pharmacists become associated primarily with cost-containment rather than patient care
Source: Chronic Disease Management - A Report for the NPA Board , accessed Oct 24, 2005
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Belfield G and Colin-Thome D, Improving Chronic Disease Management, Department of Health, 2004
Chronic Disease Management and Self Care: a practical aid to implementation of national Service Frameworks in primary care, Department of Health, august 2002
Congressional Budget Office based on the statement of Gerard Anderson,
Director, Robert Wood Johnson Foundation before the Subcommittee on
Health of the House Committee on Ways and Means, Apr. 16, 2002
Chronic Disease Management and Self Care: a practical aid to implementation of national Service Frameworks in primary care, Department of Health, august 2002
Chronic Disease Management - A Report for the NPA Board, accessed Oct 24, 2005
Munroe W et al, Economic evaluation of pharmaceutical involvement in disease management in a community pharmacy setting, Clinical Therapeutics, Vol. 19Issue 1, Jan-Feb 1997 pp113-123
