ASHP statement on the pharmacist's role in primary care.

The American Society of Health System Pharmacists (ASHP) believes that pharmacists have a role in meeting the primary care needs of patients by fulfilling their responsibilities to provide pharmaceutical care and, in states where it is authorized, through their expanded responsibilities in collaborative drug therapy management. Pharmaceutical care is the direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life. Pharmacists establish relationships with patients to ensure the appropriateness of medication therapy and patients’ understanding of their therapy, and to monitor the effects of that therapy. In collaborative drug therapy management, pharmacists enter agreements with physicians and other prescribers that may authorize pharmacists, for patients who have a confirmed diagnosis, to select appropriate medication therapies and regimens and adjust them on the basis of patients’ responses. National and international organizations, states, and health care organizations, among others, may have differing or overlapping definitions of primary care. Primary care is a concept intended to improve the quality of care received by everyone in the United States. For the purposes of this document, primary care is defined as the provision of integrated, accessible health care services by clinicians who are accountable for addressing a majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. Primary care services should be comprehensive, coordinated, and continuously provided over time by individuals or a team of health care professionals according to the patient’s needs. Services should be accessible to patients by telephone or at sites of care provision. Clinicians who provide these services are responsible for the quality of care, the satisfaction of patients, and the efficient use of resources, as well as for their own ethical behavior. Practice elements of pharmaceutical care and collaborative drug therapy management are consistent with the intents and evolving forms of primary care. ASHP supports the development of definitions and working models of primary care that recognize and incorporate the services of pharmacists for meeting primary care needs of patients. In general, pharmacists contribute to the provision of primary care through the delivery of pharmaceutical care and in collaboration with other health care providers. Furthermore, pharmacists may directly provide a limited range of primary care functions in addition to those encompassed by pharmaceutical care, either independently or in collaboration with other members of a primary care team. High-quality, coordinated, and continuous medication management for patients should be measurable as a result of the provision of pharmaceutical care within a primary care delivery model. The benefits to patients are valuable access to medication information, the prevention and resolution of medication-related problems, improved outcomes, and increased satisfaction. Pharmacists are able to use medication-related encounters with patients to provide information and either resolve or make a referral for other health care needs. The purposes of this statement are to promote understanding of the various ways in which pharmacists provide or contribute to the provision of primary care in integrated health systems and to clarify future directions for pharmacists in efforts to expand patient care services in primary care.