Emerging Practice Arenas for the Consultant Pharmacist

Abstract

The growth of the aged population and changing characteristics of the elderly and their caregivers require that alternatives to institutional long-term care be developed. The need for consultant pharmacy services can be hypothesized on the basis that a considerable number of these individuals have similar levels of disability as nursing home residents. The experience of consultant pharmacists in noninstitutional environments is reviewed in this article. These environments include health maintenance organizations, home health care agencies, and residential care facilities. Barriers to providing nontraditional consulting services include (1) a lack of a regulatory mandate, (2) lack of formal reimbursement mechanisms, (3) lack of an expectation for services on the part of other providers and administrators, and (4) lack of an assertive marketing posture on the part of pharmacists. Strategies for overcoming these obstacles are discussed. Increased reliance on noninstitutional settings for the long-term care of older citizens will increase the opportunities for consulting services by pharmacists who are willing to demonstrate to other providers that inappropriate drug use in these settings results in increased cost and decreased quality of care for clients.