The Pharmacist Role in Value-Based Care and on Multidisciplinary Teams: Eileen Peng, PharmD

In value-based care models, pharmacists play an important role in multidisciplinary team care in selecting cost-effective treatments and managing adherence to prevent hospitalizations and emergency department (ED) visits, explained Eileen Peng, PharmD, vice president, chief administrator, and pharmacy officer, Astera Cancer Care.

This transcript has been lightly edited; captions were auto-generated.

Transcript

What do you think is the future role of pharmacists in a health care system that utilizes value-based care models?

I think pharmacists can play a very important role in value-based [care], because we would know, and we are experts in selecting the correct medication [and] managing side effects. We can choose the medication that's cost-effective and manage patient adherence to avoid a lot of hospitalization or [ED] visits.

What has been your personal experience as the pharmacist in a multidisciplinary team setting?

I'm very lucky. Our providers, our physicians, they trust pharmacists. We would even get a call to say, “What do you think? Is this good for this patient?” Or if they see a lab change or [the] patient gets [a] symptom at home, our physician will call us and say, “What do you think? What should we do? Should we change treatment? Should we reduce the dose?” And we also work very, very closely with our nurses, especially the triage nurse. They reach out to pharmacists and say, “Hey, this patient has called, and this is their symptom at home. What do you think? Is there any dose reduction or any medication we can suggest for them to take it at home so they don't have to go to [the ED] but [we can] still safely manage [them] as an outpatient?”

As the pharmacist, how do you identify adherence issues, and what does counseling then look like to improve a patient's adherence?

There are 2 different treatments. There's infusion. In our practice, everything is care point–based. What day [the] patient has to come in, for what cycle, what day of treatment, and if the patient missed the treatment, we actually have our scheduler call at the end of the day and say, “Hey, you missed your treatment. Is there anything you know that we need to know [about] why you missed the treatment?”

For oral, pharmacists follow oral prescriptions very closely. We actually start reviewing physician notes [to] make sure [the] patient has a visit before their next fill. We start to review their lab and the visit notes and see how [the] patient is tolerating it if the treatment still goes on. [If treatment continues], we will actually call our patient and say, “Hey, your refill is coming up. Are you ready to receive the prescription? And how many pills do you have?” That helps us understand if they are taking their pills the right way and [that] the number of pills left is the correct number. Then, if it's right or wrong, we will also ask patients if [they] have any questions for us.

But if we identify a patient [is] not adherent, not only would we tell them how important it is to be adherent to their treatment, we also will inform our physician, and let them know, “Maybe set up an appointment and ask the patient to come in.”