Community pharmacists are playing an increasingly central role in chronic disease management.
Thanks to their expertise in pharmacotherapy and their proximity to their clientele, pharmacists are ideally positioned to provide this essential support. Their role includes facilitating access to care, improving the health of their patients, and potentially reducing costs for the health care system.
But first, a little background
In pharmacy, the management of chronic diseases involves regular, personalized follow-up with patients with long-term illnesses. The purpose of these follow-ups is to monitor the efficacy and safety of treatments and to optimize therapies based on how each person's condition evolves.
This may involve adjusting the dose of a medication the patient is already taking or selecting another, more appropriate treatment. Health education is also an integral part of pharmacy care. However, as this chart from the Canadian Pharmacists Association shows, pharmacists' scope of practice varies from province to province.
In recent years, the impact of pharmacy management of various conditions has been assessed numerous times. Here are two examples of how the intervention of Canadian pharmacists has had a significant impact:
- The New Brunswick Pharmacis't Association recently demonstrated that pharmacists could speed up patient care by 8 weeks or more, particularly for the 36 percent of New Brunswickers living with diabetes or prediabetes.
- In Nova Scotia, a pharmacy primary care clinic pilot reduced emergency department visits for less urgent conditions by 9.2 percent.
Yet, despite the critical role pharmacists play in the health care system, a number of challenges and obstacles continue to restrict their ability to treat patients with chronic diseases.
In this article, we will explore some of these challenges, as well as emerging solutions designed to support pharmacists in their mission. We'll also be talking about Chroma, a module integrated into RxConsultAction that will be launched in 2025.
A number of complex challenges
Chronic disease management in community pharmacies presents a number of complex challenges. Here are just a few of them.
- Interprofessional collaboration is essential to providing comprehensive and safe patient care. However, pharmacists often rely on outdated tools such as fax machines to communicate with other health professionals, which slows down the process and increases the risk of errors. Updating these tools would lead to smoother, safer patient management.
- To make informed decisions, pharmacists rely on multiple sources of information. Although access to this information is essential, the sheer volume of it can make it hard to review and synthesize. Guidelines are not always presented in the most user-friendly way, and given the frequency of updates, pharmacists must make an ongoing effort to stay current. For these reasons, tools capable of centralizing and synthesizing data have become a necessity.
- Not all people with chronic illnesses require the same level of care, and identifying priority cases remains a complex task for community pharmacists. There are, however, a number of criteria that can be used to target those individuals who could benefit most from closer care. These include:
- The complexity of the patient's pharmacological profile
- The absence of other professionals involved in the case
- The vulnerability of certain populations (e.g., the elderly or those with cognitive impairments)
*Note that some tools, such as the RxIntensi-T score integrated into RxVigilance , automatically assess the complexity of pharmacological profiles, making it easier to identify patients requiring special attention.
- Cumbersome administrative tasks such as insurance management and repetitive data entry into multiple systems take up a lot of time. As a result, pharmacists are less available to provide direct patient care. A technological solution that integrates administrative functions into the patient management system would speed up workflow and free up time for clinical interventions.
In addition to these challenges, several other factors complicate chronic disease management in community pharmacy practice. These include:
- The difficulty of ensuring continuity of care and providing personalized interventions despite time constraints
- The pressure to maintain service profitability without compromising the quality of care
- The growing need for integrated clinical tools for optimal treatment follow-up.
Every obstacle requires its own solution.
A forward-looking solution: Vigilance Santé's Chroma module
The Chroma module, currently under development at Vigilance Santé, is an innovative response to the challenges of chronic disease management in community pharmacies. This new module is designed to support chronic disease management through a comprehensive set of features—data collection, therapy review, decision support, creation and updating of action plans—tailored to the specific requirements of each province.
Here's how it addresses common challenges:
- Simplified data collection. From the moment a patient's file is created, Chroma makes it easy to add information specific to their profile and chronic conditions for fast, accurate needs analysis.
- Contextualized interventions. Suggested interventions will be integrated and adapted to the patient's profile for personalized care.
- Document generation compliant with provincial requirements. Chroma will automatically generate all required documents, in line with provincial legal requirements, and simplify invoicing to lighten the administrative burden.
- Integration with pharmacy management systems (PMSs). By connecting to PMSs, Chroma will eliminate the need for duplicate data entry, another factor that will cut down on administrative tasks.
- Dynamic patient monitoring. Users will be able to update the action plan, and completed actions will be documented or archived, ensuring thorough clinical management and up-to-date data.
- Instant access to data and alerts. Leveraging the Vigilance Santé ecosystem, Chroma will provide information on drugs and clinical alerts to ensure patient safety.
The future lies in innovation
For community pharmacists, providing chronic disease management services represents a commitment to improving their patients' quality of life.
However, the technological, administrative, and clinical challenges presented by this type of care are constantly evolving.
Therefore, it's encouraging to think that we will soon be able to rely on innovative solutions that will lighten the administrative burden, facilitate data management, and allow for more personalized and safer interventions.
That's why I'm delighted to contribute to Vigilance Santé's efforts to provide my peers with cutting-edge tools that will enable them to focus more on what matters most: their patients' well-being.
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This article was written with the support of some of my fellow pharmacists at Vigilance Santé: Martine Gagné, Angela Sheung Wai Chang, Julien St-Denis, Louis-Philippe Lafleur and Anthony Tétreault.
