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Despite a significant body of evidence supporting pharmacist-provided services, gaps remaining in the evidence base need to be addressed to accelerate the adoption of pharmacy services into evolving health care delivery models. Understanding these gaps is important in targeting research efforts...we have reached a critical time in the evolution of pharmacy and pharmacist-provided services...we must carefully consider the research questions that are most relevant to advance pharmacy practice...As health care transitions toward value-based care, it is important that we demonstrate the role of the pharmacist as an integral member of the health care team in optimizing medication use and improving patient care. We need to rethink our...research and shift some of our efforts to the translation and implementation of research findings...Efforts to demonstrate that pharmacist-provided services work...should continue; however, we must place more emphasis on how to integrate best practices in pharmacy-provided services into value-based care delivery and payment models.

The role of pharmacists on an athlete’s health care team is a growing component of getting athletes ready for competition...Teams have a need, and pharmacists are positioned to help...Athletes suffer from the same conditions everyone else does. They can benefit from a pharmacist’s intervention…...late 1990s, pharmacists were providing medication management software tools to track usage. Athletic teams’ medical and training staff would use the information to streamline their work, and a demand for pharmacists’ services began...steroid and doping controversies...(also) provided compelling reasons for teams and medical personnel to track and monitor drug usage…(this) tells only part of the story of what services pharmacists provide...compounding expands the tools and treatment modalities available...Nutrition is another area...Dietary supplements are a big problem...because they can contain banned substances that are not listed on the label...A pharmacist can guide athletes and direct them to supplements from trusted sources...While opportunities to work with professional athletes are few, opportunities for pharmacists to apply their knowledge and training with athletes abound...There are opportunities for involvement in sports...that would allow pharmacists to use their skills...The field is wide open…Pharmacists have to create their own opportunities by being pioneers and getting their foot in the door...Understand your field and establish your reputation and credibility so providers can call upon you as a trusted colleague and resource. Then develop your expertise in sports.

More than 40 members of the House of Representatives have expressed support for greater pharmacist roles in improvements made to Medicare Part D’s medication therapy management program...CMS announced plans to improve MTM with its Part D Enhanced MTM model in September 2015. The enhanced model aims to look at additional incentives and flexibilities to achieve the goals of the program...Some of those goals include increased communication with pharmacists, prescribers, and patients; improved patient knowledge; reduced medication problems; and improved compliance with medication protocols...The enhanced MTM model test will launch in January 2017...Some of the medication adherence concerns that the Congressional members noted were:

• Nonadherence costs the United States $290 billion annually and makes up 13% of total health care expenditures.
• Patients with several chronic conditions comprise two-thirds of all hospital admissions and are 100 times more likely to have a preventable admission.
• These patients with several chronic conditions visit many different physicians in a year and receive around 50 prescriptions annually on average.
• MTM is currently poorly integrated into health systems. 

Congressional leaders called for retail pharmacists to be included in the enhanced MTM models that will be tested, citing how pharmacists have been shown to improve patient health, reduce costs through fewer hospitalizations and readmissions, and increase patient involvement in their own medication management...Our seniors deserve the most robust and effective MTM program possible—one that includes the utilization of the most trained and highly skilled providers medication management services: local retail community pharmacists...

California is set to become one of the first states where women can get birth control from a pharmacist without a prescription with the goal of reducing unwanted pregnancies...Proponents of the new law say it will give younger women easier access...But doctors like gynecologist Kathleen Valenton have concerns...“I think that’s very dangerous,” she said, since pharmacists cannot perform health screenings, including STD checks...Many of the details of the law are still being worked out in Sacramento. It is set to take effect in March.

Thirty-three community pharmacies have taken part in North America’s first research project that ultimately aims to bring the science of pharmacogenomics to patients using their community pharmacy. Pharmacogenomics uses a person’s genetics to uncover which drugs and in what dosage work best for them...The project, called "Genomics for Precision Drug Therapy in the Community Pharmacy", was funded by the BC Pharmacy Association and Genome British Columbia with research being done by a team at the University of British Columbia’s Faculty of Pharmaceutical Sciences...he project set out to position the pharmacist as the health-care provider through which patient genetic information can be acquired, assessed and used to guide drug therapy decisions...This is where the future of pharmacy is heading...We showed that pharmacy can be the gateway to personalized medication in our communities...Regardless of the location – urban or rural – patients had a consistent, quality experience with their community pharmacist as it relates to pharmacogenomics....

The campaign to pass the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314) made major strides in 2015. The legislation enables patient access to, and coverage for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. H.R. 592 was reintroduced in the House of Representatives in January 2015… a companion bill, S. 314, was introduced in the Senate...APhA continued its leadership role in growing support for the legislation. PharmacistsProvideCare.com, APhA’s website dedicated to the campaign on provider status, was revamped with information, resources, and tools to help pharmacists advocate to elected officials, policy makers, and decision makers…At the state level, 94 bills—three times as many as last year—were introduced to address patient access to pharmacists’ care. Sixteen bills were introduced on the definition of pharmacists as providers; 53 bills were introduced addressing scope of practice issues, including collaborative practice agreements; and 25 bills were introduced on payment for services. In January, the National Governors Association issued a report recognizing the value pharmacists provide in improving public health and urging states to "consider actions to expand pharmacists’ scope of practice." In April, North Dakota passed a series of measures increasing opportunities for pharmacists and their patients. Other states like Washington and Oregon followed suit..."Our goal in 2016 is to keep the momentum going,"…."In addition to success at the state level, we hope to see continued progress on federal legislation."

Oregon is making hormonal birth control legally available without a doctor's prescription, and California is set to follow suit. This is great policy, and the rest of the country should follow this example...Before I explain why they should, we should dispense with the policy hopes that easier access to birth control won’t fulfill:

• It won’t end the political fight over the contraception mandate.
• It won’t end the political fights over abortion, either. Easier access to birth control is a great thing. But there is surprisingly weak evidence that making birth control easier to get substantially reduces abortion rates.
• It won’t save the health-care system any significant amount of money.

There are still very good reasons to make birth control available without a doctor visit, starting with the fact that women like it...Absent a compelling reason that women need to see a doctor, it should be as easy as possible for them to get any form of birth control they might like to have...Advocates for keeping doctors involved in dispensing birth control have historically used two arguments.

• The first is that the drugs have side effects -- which is true, but of course, also true of over-the-counter medications...
• The second argument is that we need to keep doctors involved so that women will keep coming to the gynecologist to get their annual exam and pap smear.

Modern technology is now making genomic testing possible for a fraction of the time and cost..Now pharmacists and physicians can use pharmacogenomic test results to help choose safer and more effective medications for their patients...Pharmacists are undoubtedly the pharmacokinetic experts and the most educated health care providers in regard to the cytochrome P450 system. Preemptive genotyping would make a nice addition to a pharmacy’s list of service offerings and point-of-care testing panel...A clinical consultant pharmacist could use pharmacogenomic testing to guide therapy decisions and decrease drug–drug interactions. This has the potential to save countless health care dollars lost to ineffective medication use, adverse drug events, and hospital readmissions...There are also financial benefits for the testing pharmacy. Looking at pharmacogenomic testing from a medication therapy management perspective, one can imagine the usefulness of integrating genomic testing into a patient’s comprehensive medication review...to make specific evidence-based recommendations to improve patient care.

• Proven cost savings in elderly patients
• Help in predicting and preventing adverse drug reactions
• Decreased hospitalizations due to treatment failure
• Prevention of “trial-and-error” prescribing

Pharmacists are the experts on medication safety and effectiveness, and should be ready to take on the role of personalized medication consultants...Innovation is essential if pharmacy wants to act on new clinical service opportunities and earn a seat at tomorrow’s health care table. We need to be proactive in seeking out new niches...

To realise new ways of working means moving away from traditional professional boundaries and enabling the pharmacy workforce to take on different roles if it benefits patients...the demand for pharmacists’ clinical skills as medicines experts continues to grow. Medicines optimisation spans all pharmacy services....In order to deliver this, maximising the skills, knowledge and experience of the rest of the pharmacy team is an absolute necessity...As pharmacists’ clinician role continues to evolve and become embedded in new areas...pharmacy technician, can help to support them.

• Education and training...realigning functional tasks and providing confidence in delegating duties is to ensure there is a defined education and training pathway that assures the public and the profession of a competent practitioner at every level.
• Expanding roles...Pharmacy technicians, as registered and accountable professionals working across the same pharmacy environments as pharmacists, can be used to release pharmacists’ time to undertake additional clinical responsibilities.
• Blurred roles...The expanding responsibilities of pharmacy technicians may help give clarity to the role...However, there is no clear distinction between a newly registered pharmacy technician and a dispensing assistant...requires greater clarity around the role of the dispensing assistant...This must be resolved if pharmacy technicians are to further their practice and help release pharmacists to conduct more clinical work.
• Working together...Pharmacy technicians will not be substitutes for pharmacists but, as foundation practitioners, they can work closely together, exercising autonomy and judgement within limited parameters...Working together for the benefit of patients will allow pharmacy to embrace the changes that are needed to relieve pressure on the UK healthcare system.

Pharmacists in Oregon are now permitted to prescribe birth control pills to qualifying women as part of a wave of new state laws for 2016...Oregon is the first U.S. state to put such a law into effect, with California reportedly looking to follow suit...A doctor's approval is no longer needed for a supply of pills, although experts urge women not to overlook preventative health care in the form of doctor visits...having birth control accessible through a pharmacist doesn't mean preventative health care isn't important...women over age 18 will still be required to fill out a health questionnaire trained pharmacists will use to determine whether to write a prescription. Pharmacists are reportedly still free to refuse prescriptions for religious reasons, but must refer a customer somewhere else.