Creating the CDC guide on pharmacists as partners

The story behind CDC's new chronic disease guide

CDC recently released A Program Guide for Public Health: Partnering with Pharmacists in the Prevention and Control of Chronic Diseases. Intended to help CDC grantees build relationships with pharmacists, the guide shows how the role of the pharmacist has expanded into chronic disease management as a part of team-based care (see page 64 of October Pharmacy Today).

“For many years, CDC was not aware of the role of the pharmacists and their potential role in public health and chronic disease management,” noted Magaly Rodriguez de Bittner, PharmD, BCPS, CDE, Professor and Chair, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy; Executive Director, Center for Innovative Pharmacy Solutions; and one of three pharmacists named on the guide’s acknowledgments page. “It is really remarkable that CDC, such an important federal agency, is promoting the positive role of pharmacists and encouraging others to partner with us.”

Evidence is the spark

CDC’s Division for Heart Disease and Stroke Prevention and Division of Diabetes Translation contributed to the guide; their home pages link to it.

“The impetus for the guide was evidence supporting team-based care, including pharmacists, in increasing control of high blood pressure,” said co–lead author Cynthia M. Morrison, MSPH, Health Education Specialist, Division for Heart Disease and Stroke Prevention, CDC. Both divisions “saw this as an emerging opportunity.” (The other co–lead author was Denice Glover, MSW, Public Health Analyst, Division of Diabetes Translation, CDC.)

When CDC began creating the guide, many state health departments did not have experience in partnering with pharmacists, Morrison told Today. “Now, we have seen a tremendous increase in interest in state health departments wanting to work with pharmacists,” she said. “The states I’ve talked to, they’re finding it very helpful. They said, ‘This is right on time.’”

From start to finish

The project had strong program management. Through a series of roundtables, workshops, and conference calls, CDC received feedback and guidance from practicing pharmacists, representatives from professional pharmacy organizations, patient advocacy groups, and patient ambassadors, according to CDR Sherri Yoder, PharmD, BCPS, U.S. Public Health Service, Indian Health Service Pharmacy Program.

As it turned out, work by APhA produced a model document for the CDC guide. “We really got a lot of information from” APhA’s Pharmacists and the Health Care Puzzle: Improving Medication Use and Reducing Health Care Costs, explained Morrison. “When we looked at this document, almost everything we wanted to say was in there.”

The CDC guide referred to not only Pharmacists and the Health Care Puzzle but also Improving Patient and Health System Outcomes through Advanced Pharmacy Practice: A Report to the U.S. Surgeon General 2011. Yoder, a coauthor of the report, clarified that the report discusses “the comprehensive services that pharmacists currently provide,” not only comprehensive medication therapy management services as inadvertently stated in the guide.

Also named was Philip T. Rodgers, PharmD, BCPS, FCCP, Assistant Dean of Pharmacy Practice Partnerships and Clinical Associate Professor, University of North Carolina Eshelman School of Pharmacy. “The guide defines and illustrates the role pharmacists can play at multiple levels of practice and concisely summarizes some of the major projects and studies that have demonstrated the importance of pharmacists on the health care team,” he explained.

There was no funding for the guide “other than staff time,” according to Morrison.

High hopes

Rodgers serves as the APhA representative to the National Diabetes Education Program, a collaborative program among CDC, the National Institutes of Health, and many professional partners. “I hope the guide will inspire nonpharmacists and interdisciplinary teams to consider incorporating pharmacists into their projects and proposals to promote the high value of pharmacists in the management of patients with chronic disease,” he said.

Rodriguez de Bittner is Director of the Maryland P3 Program, a chronic disease program that works closely with CDC and receives funding from the Maryland Department of Health and Mental Hygiene. “My hope is that other [state] departments of health use the guide to recognize the role of the pharmacists and replicate the P3 program in their states,” she said. “The guide is also useful for [pharmacist] advocacy.”