Kristen Bole, UC San Francisco
UC San Francisco and Walgreens have opened a unique Walgreens store on the UCSF campus that aims to improve medication safety, decrease health care costs and help patients use medicines more effectively by offering pharmacist-based patient care and expanded health and wellness services to the community. A joint effort between Walgreens, the UCSF School of Pharmacy and UCSF Medical Center, “Walgreens at UCSF” also will explore new models for improving overall patient care.
“Walgreens at UCSF is an ideal environment for our pharmacists to work with UCSF Medical Center and School of Pharmacy faculty to further innovate in health care while providing greater access to services for the surrounding community,” said Joel Wright, Walgreens divisional vice president, specialty solutions group. “At Walgreens, we are very pleased to share and develop best practices with UCSF pharmacists and pharmacy students, which further our commitment to help people get, stay and live well.” Walgreens at UCSF, located across the street from UCSF Medical Center, is one of Walgreens “Well Experience” stores, which offer expanded health services and are designed to foster increased patient-pharmacist interaction. With an expanded pharmacy including multiple areas for private consultations, Walgreens and UCSF pharmacists and UCSF pharmacy students are more accessible to community members and patients.
Core clinical health services include medication counseling by a pharmacist as the standard of care and comprehensive medication reviews for customers who receive prescriptions. Pharmacists will work with patients to create and update accurate, portable medication lists to take to their appointments with medical providers. This approach can help decrease drug-drug interactions and encourage patient medication adherence.
“Modern medicine has transformed many diseases from urgent, life-threatening conditions into chronic illnesses that can be managed with the right medications, but that means more and more patients are juggling multiple prescriptions, with complex instructions,” said Joseph Guglielmo, PharmD, a leader in the field of clinical pharmacy and dean of the UCSF School of Pharmacy. “And, in many instances, this complicated medication list is inaccurate and incomplete. This collaboration aims to transform the practice of community pharmacies to enable pharmacists to do what they’re trained to do, which is helping patients manage their health with the right medications and understand how to take them correctly.”
The collaboration builds upon Walgreens’ leadership in pioneering new approaches to pharmacy care, as well as UCSF’s long history of collaboration in teaching, research and patient care between the School of Pharmacy and UCSF Medical Center, which together piloted the first hospital-based clinical pharmacy program in the nation, in the 1960s.
The project comes at a time when an estimated 82 percent of Americans use daily medications to manage their health and 29 percent take five or more medications, according to the Centers for Disease Control and Prevention. Yet the National Consumers League reports that three of every four Americans say they do not always take their medications as directed, and an estimated one-third of all patients do not fill their prescriptions. The result is a high rate of both medication errors and readmissions to hospitals for patients whose illnesses could have been managed at home.
“Every time a patient is readmitted to the hospital because they did not take their medications, it has a direct impact on both their health and their health care costs,” said Daniel Wandres, PharmD, chief pharmacy officer of UCSF Medical Center. “By creating this three-way collaboration, we hope to create a national model for eliminating medication-related readmissions and reducing medication errors nationwide.”
Medication errors are one of the leading causes of harm to patients, including 7,000 deaths and at least 1.5 million injuries each year, at a cost of over $3.5 billion nationwide, according to the Institute of Medicine. A number of studies have shown that incomplete medication histories are common upon hospital admission, with as many as 95 percent of patients’ records having at least one error in their list of medications, wrong doses or frequencies, or discrepancies in allergies or prior adverse drug reactions. Additional studies show that discrepancies in medication information occur in up to 70 percent of patients upon hospital discharge.
The new pharmacy model also comes on the heels of the California provider status law based on Senate Bill 493, which took effect Jan. 1, 2014, expanding the role of pharmacists on the patient care team. Under the new bill, pharmacists can perform additional healthcare responsibilities within the realm of their expertise, such as furnishing certain medicines, monitoring patient health and adjusting prescriptions, as needed.
Walgreens at UCSF will provide a contemporary space in which pharmacists can practice at the top of their licensure, while serving as a training ground for student pharmacists during the experiential portion of their doctoral degree program at UCSF and as a clinical training site for pharmacy residents. Walgreens at UCSF aims to improve patient outcomes by refining and developing medication management methods and pharmacy-patient care models.
UCSF Medical Center continually ranks among the nation’s top ten hospitals by U.S. News and World Report and was named the best hospital in Northern California in its 2013-14 “America’s Best Hospitals” issue. The UCSF School of Pharmacy is ranked first by U.S. News and World Report for its doctor of pharmacy degree program and has led its field in research funding from the National Institutes of Health for 34 years.
