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How Can Pharmacists and Physicians Work Together to Optimize Patient Care?


Kerry LaPlante, professor of Pharmacy, University of Rhode Island, adjunct professor of Medicine, Brown University, director of the Rhode Island Infectious Diseases Research Program, and Infectious Diseases Pharmacotherapy Specialist, Providence Veterans Medical Center, discusses how pharmacists and physicians can work together in the hospital setting to optimize patient care.
Interview Transcript (slightly modified for readability)
“As we know, antibiotics are a scarce resource for us right now, and drug resistance is an important public health concern. I think we’re at [a] time where we need to work together with physicians, pharmacists, microbiologists, and nurses as an interdisciplinary team and do what we can for the patient. These relationships are all based on trust, they’re based on partnerships, and everyone has a unique but important role in treating the patient to get the best outcomes and to keep our patients safe. [An] example [is] the role of the pharmacist, and the evolving role of the pharmacist. Really, when it comes to selecting the right drug at the right dose for the right duration, in empiric therapy, what we can do is work together, pharmacists and physicians, to create pathways and guidance documents for the rest of the treating team, for the patients.
When it comes to selecting the right dose, what pharmacists have good expertise in is making sure that the patient, if they have renal failure, if they have liver failure, if they have other drug-drug interactions, or other things going on, can [get an] optimized drug therapy [regimen]. [For] duration, IDSA guidance give us recommendations on how long to treat patients, and this is something that, with policies and procedures in place at a hospital, pharmacists can help work with physicians and enforce.
What we do at our clinical practice is, for example, every day the pharmacist will pull all antibiotic use and all blood cultures from the microbiology lab, [and] we review that, we look for appropriateness, correct drug, dose, and duration. When there are simple changes, like IV to oral switch, when they’re deescalating therapy because the culture is back, when there’s no growth and we have to stop the therapy, that’s when the pharmacist will come in and have those conversations with the team. When there [are] more challenging cases, that is when we’ll bring in our infectious diseases physician who will call surgery or urology and get a little more understanding on the [pathophysiology] or what specifically is going on with that patient.
I think we play a very important role; it’s certainly a team approach. I heard a colleague say ‘wouldn’t we want a two-parent household? Wouldn’t we want a mom and a dad? Wouldn’t we want an ID physician and an ID pharmacist working together to do the best we can for our patients?’ I think that pharmacists have an important role, and ID physicians, nurses, microbiologists, we all need to work together.”
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