Personal Service at Your Pharmacy: More Stores Stress the Role Druggists Can Play in Helping Customers Get and Stay Healthy

By Sabine Vollmer, The News & Observer, Raleigh, N.C.

Dec. 21–Do you have high blood pressure? Are you having trouble managing your diabetes medicine?

Talk to your pharmacist.

For the past two years, drugstore chains have been boosting their pharmacists’ roles by introducing programs to help customers manage their health.

Raleigh-based Kerr Drug has health-care centers in about 16 of approximately 160 stores it has in the Carolinas; it plans to add more. Customers can get one-on-one diabetes education, flu shots and wellness assessments in those centers.

Its larger rivals, CVS, Walgreens and Rite Aid, have similar programs and are looking to offer more nationwide.

The services make sense, said Laura Miller, senior economist at the National Association of Chain Drug Stores.

They could reduce medication misuse. A 2001 University of Arizona study said that about $177 billion is wasted every year on hospital admissions, emergency room visits and doctor visits because of drug interactions, improper drug selection, overdoses or failure to receive a prescribed drug.

Health-care programs also help drugstore chains build customer loyalty in a competitive environment, said David Magee, a retail analyst at Sun Trust Robinson Humphrey who tracks CVS and Walgreens. “Anything you can do to get people into your store is a positive,” he said.

Once in the store, customers come to trust the pharmacist and tend to return, he said. On each visit, they might pick up a few greetings cards, a candle and a pack of gum, too.

Pharmacists adapt

Increasing customer traffic has been a challenge for drugstore chains.

Since the early 1990s, grocery stores, large discount chains and warehouse stores have added pharmacies to draw more customers. Drugstore chains responded by buying competitors and adding stores. Now, they’re emphasizing the role of the pharmacist.

“The pharmacist is the most underutilized health-care provider in the system,” said Rebecca Chater, director of clinical services at Kerr Drug.

Once drug makers relieved pharmacists of responsibility for compounding and mixing medicine, pharmacy schools began training students in medication management.

Pharmacy students learned to substitute cheaper generic versions of brand-name drugs, eliminate duplication and make sure that drugs that interact aren’t taken together. But those skills weren’t always highlighted behind the pharmacy counter.

The push toward health-care management allows pharmacists to use those skills more often. It also allows drugstores to target a growing market.

Helping baby boomers

Millions of Americans have chronic diseases such as diabetes, and their numbers are expected to increase as the first wave of baby boomers get ready to draw Social Security checks next year. Many can use a helping hand to keep health-care costs from ballooning.

In 2005, nearly 15 million Americans knew that they had diabetes, and 1.5 million new cases were diagnosed, according to the American Diabetes Association. The same year, one in 10 of the nation’s health-care dollars went to treating diabetes.

Combine diabetes, obesity and high blood pressure, and patients’ risks for cardiovascular disease multiply. The cost of heart attacks, strokes and other cardiovascular diseases was estimated at more than $400 billion in 2006, the American Heart Association says.

Americans 60 and older make up the largest group of diabetes and cardiovascular patients. Most of the health-management services that pharmacists offer are geared toward that age group.

CVS and Rite Aid offer free tip booklets for diabetes patients and will demonstrate blood-sugar meters.

Other services the four chains offer include bone density screenings for osteoporosis, healthy heart screenings and wellness checks to assess customers’ risks of diabetes and cardiovascular disease.

Last year, Rite Aid organized an expo in Pittsburgh for people who care for a spouse, parent or relative, and the drugstore chain might take the event to other areas.

Walgreens is considering expanding its home care program for customers who need a nurse for respiratory care or infusions.

Even independent pharmacies, which usually have fewer resources, are expanding their customer services.

Paul Ashworth, owner of Ashworth Rexall Drugs in Cary, said that next year, he plans to start monitoring the medications of Medicare patients who take several prescriptions.

Medicare Plan D insurance plans reimburse pharmacies for many of the programs. The insurers’ computers also flag such patients and offer pharmacists incentives to look for cost savings, such as eliminating prescriptions that are duplicated or substituting generic versions of brand-name medicines.

‘Wonderful’ new role

Pharmacists can reinforce what patients learn from their physicians, work with physicians to monitor patients’ medication and make sure patients take medicines properly, said Cherry Graves, a family nurse-practitioner.

“We can use pharmacists in wonderful ways,” said Graves, who works in Dr. David Adams’ office in Cary.

For the system to work, pharmacists have to make sure patients understand the advice and use it, she said.

But drugstores and pharmacists have to be sure they don’t “cross the line of practicing medicine,” she said.

Kerr Drug has the most extensive offering of health-care management programs. It has developed a diabetes education program that includes seven visits and is recognized by the American Diabetes Association.

Physicians refer diabetes patients to Kerr Drug pharmacists for counseling and blood sugar monitoring and to a nutritionist to learn about diet. The classes cost about $300 and are covered under Medicare Part D plans. Many other health insurance plans don’t pay for them.

Stan Combs, 72, of Cary, was on his third visit with Gretchen Jenkins, a pharmacist and the clinical coordinator at Kerr’s store on Buck Jones Road.

A diabetes patient for about six years, Combs has had heart bypass surgery and a stroke. His blood sugar level is out of control, and he recently switched from pills to insulin injections. He is fighting high cholesterol and taking eight prescription drugs.

“I’m in a panic with my diabetes, and I don’t feel so good,” Combs said. “Exercise and pills don’t control it anymore.”

Jenkins has shown him how to use the insulin pen for convenient injections, replaced his malfunctioning blood sugar meter with a newer, more convenient model and given him advice about nutrition. To adjust the amount of insulin Combs is taking, she sent him back to the doctor.

“She’s my psychologist, and she tells me what I’m doing wrong,” Combs said. And she does it nicely, quickly and without embarrassing him, he said. “That makes a lot of difference.”

sabine.vollmer@newsobserver.com or (919) 829-8992

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