Home Pharmacy practice Pharmacists can prepare to play a growing role in holistic health and wellness efforts

Pharmacists can prepare to play a growing role in holistic health and wellness efforts


In an interview with Pharmacy hours At the National Association of Chain Drug Stores (NACDS) 2022 Total Store Expo, Rina Shah, PharmD, Group Vice President of Future Pharmacy and Healthcare Segment Strategy at Walgreen Co., discussed the growing role of pharmacists in promoting holistic health and wellness for patients.

Q: Health equity has become a major priority for healthcare in recent years. What role does pharmacy play in improving health equity?

Rina Shah, Doctor of Pharmacy: Yes, I think it’s something that even before health equity was the word everywhere, pharmacy has had a role in health equity since the dawn of time. Pharmacies, and specifically Walgreens, are within 80% of the 5 miles of patients who live across the country. And when you look at all pharmacies, pharmacies are located within 5 miles for 90% of the US population. So when we think about access to care, many of the communities we serve within the pharmacy are truly the first point of contact for patients looking not only for their pharmacy needs, but even just to find out where they want go for help. ? Should I see the doctor, take an OTC recommendation?

So it’s something we’ve been doing since the beginning, but over the last two years it’s definitely skyrocketed. You know, we’ve been able to expand vaccination services and testing services in areas that we know require increased access to care in a different capacity than we had in the past.

Q: How does pharmacists’ position as the most accessible healthcare providers enable them to help patients make lifestyle changes, such as improving their diet or improving their fitness levels?

Rina Shah, Doctor of Pharmacy: Yes, you know, at least at Walgreens we look at things around 3 specific pillars. The first is prevention, and so around prevention, we educate our patients about vaccinations, vitamins, making sure everyone stays healthy and gets screened, making sure they understand how they have access to these types of services and why it is important. And it’s not just on the prevention side, it’s also on the treatment side. So if something happens, make sure we understand, and that our patients and customers know what they can do about the treatment. It can be over-the-counter products or things that are behind the counter. And then there is the management. So, a key thing is in someone with diabetes, it is important that they get an A1c test every two months just to make sure they are managing their diabetes. We spend a lot of time training our pharmacists and technicians so that they can talk to their customers about the tools and resources available to them. And it’s not just on the testing side, but it’s nutrition and making sure there are healthy choices and what they can do, just, you know, take action and s ensure they lead the health care lives we need, so they can stay healthy. So that was great to see. we have about 15-20 stores in Chicago, where we are testing different ideas to help increase access, especially in underserved communities. And so we call them our incubator sites. And so we test different pilots and ideas and see what sticks and based on what sticks we go ahead and launch it nationally.

Q: What potential policies are being discussed or have been adopted to improve health and well-being?

Rina Shah, Doctor of Pharmacy: You know, it’s really critical. We learned during the pandemic that when you expand the scope of practice to allow pharmacists to use their full license and you also have a method of reimbursement so that our pharmacists and pharmacy technicians can be paid for that, the sky is the limit. We’ve seen vaccination rates and testing, access to testing services specifically in underserved communities increase and we’ve been able to see an impact because of that. So from a policy perspective, we’re really taking what we’ve learned from the pandemic and expanding it. And so there’s a bill at the federal level that we’ve submitted – HR 7213, for those who may not be as familiar with it – but in fact it’s meant to broaden the scope so that our pharmacists can continue on this path to increasing access to care, especially in underserved communities. And then working at the state level so that at the state level we can also enable different capabilities – maybe flu testing and treatment, exposure to PrEP and PEP against the HIV, working with providers in the community, so we can scale up what our providers and nurses are doing, and then leverage our pharmacists to help supplement what’s happening.

Q: How do health and wellness needs and goals vary from community to community?

Rina Shah, Doctor of Pharmacy: Ultimately, health care is local. So, you know, it’s important that we have broad goals, but really what’s needed in Chicago is very different from what might be needed in a Texas suburb or Atlanta. And that’s where it’s really important that we leverage data and actionable data in the right way. And so, we’ve partnered with the CDC and other entities to take localized information to customize our programs to meet community needs. And so, we have targets, again, overall we know we want specific vaccination rates, we want to make sure patients are adherent 90% of the time, but how we can get there really depends on what is needed in that local community.

Q: How can policies and efforts be shaped to meet these different needs?

Rina Shah, Doctor of Pharmacy: You know, the infrastructure is what really needs to be tweaked. And so if we’re able to expand access to care by expanding the scope and making sure there are reimbursable services that our teams can provide, then there’s flexibility in the system so that meets the needs of local health care, or the needs of the communities we serve. And so really, at the federal and state level, if we can keep it as broad as possible, it just allows for a lot more autonomy and what’s needed locally at the end of the day.

Q: Where do you see the role of pharmacists in the future when it comes to health and wellness efforts?

Rina Shah, Doctor of Pharmacy: Yes, I’m very excited about what the future of pharmacy can look like, especially the impact we’ve had in underserved communities. What this has shown is that there is a need, that there are health care deserts all over the country, that there are patients who do not have access to care. And our pharmacists, our pharmacies, are well placed to be able to serve that. But there are many things that have to happen. We’re transforming the model right now. You know, it’s important that we mitigate and take a lot of the work that’s done in the pharmacy right now and automate that, digitize it, being able to leverage technology. And so, at Walgreens, we’re spending a lot and investing so that we can really make it a lot more efficient for our teams, so that our pharmacists and our team members can then pivot and focus on those additional care services. And so, I’m excited over the next 18 months, a lot of things are going to change. You know, we’re looking to radically change that model so that we can deliver services and help our patients in a different way than we did before.

Q: This all seems to be part of a larger trend towards holistic health for the individual patient. How does this expanded focus change the roles of pharmacists?

Rina Shah, Doctor of Pharmacy: Yes, you know, we already play a vital role in ensuring that patients adhere to therapy. But we know that, for example, if someone is diabetic, or someone has just been diagnosed with HIV, it’s much more comprehensive in what we have to provide. So for diabetes, nutrition, health, being able to connect with the provider, offering testing services, identifying gaps in care, you know, making sure patients know they need to be screened for eyesight and a foot exam. These are aspects that we are working on, so that our pharmacists can play this navigational role, where they themselves may not be the expert, but they can direct patients to the appropriate resource. Hence our investment and partnerships with Village Medical and to ensure we have primary care in our locations we have an app called Find Care so that if our pharmacists identify a gap they are able to guide the patient to through online resources that can help them manage their conditions, right down to the point of that individual prescription, really looking at it holistically so that we’re helping that patient end to end.

Q: Is there anything you would like to add?

Rina Shah, Doctor of Pharmacy: You know, I just think our pharmacists, and all pharmacists in general, are just amazing public servants, and what’s been accomplished during the pandemic has been absolutely amazing. And so just a big thank you to all of our pharmacy teams for what they do every day to serve their communities. And I’m really looking forward to seeing what the sequel will look like so that we can continue to improve the experience not just for our team members, but ultimately for our patients.