As healthcare continues to advance towards innovative, team-based models of care, the partnership between Nurse Practitioners (NPs) and Pharmacists is a collaboration shown to improve care. A recent review, “Nurse Practitioner-Pharmacist Collaboration in Telehealth: Review of the Literature,” explores how these two roles complement each other, providing valuable insights into models of collaboration, shared responsibilities, and the benefits for patients and providers alike.
Understanding Roles in Healthcare
NPs and pharmacists each provide unique but essential roles in the delivery of patient care. NPs provide comprehensive care that includes diagnosis and management of acute and chronic disease states. Pharmacists are medication experts with extensive knowledge of medication properties, formulations, and biologic effects enabling them to ensure safe and effective medication use in a variety of settings such as community pharmacies, ambulatory care practices, hospitals, and long-term care. Both professions employ a patient centered approach to care and may provide patient and family education about a condition, medication, side effects and overall health management. In addition, depending on state regulations and collaborative agreements, NPs and pharmacists may also prescribe medications, monitor effects and adjust dosage. Both professions are essential members of the healthcare team and have shown that working synergistically can improve overall care.
Pathway to Becoming a Pharmacist
Becoming a pharmacist requires specialized education and training. The journey begins with undergraduate coursework in subjects such as chemistry, biology, and mathematics; this coursework usually results in a bachelor’s degree although this is not required. Undergraduate education is followed by the pursuit of a Doctor of Pharmacy (Pharm.D.) degree from an accredited pharmacy school, which typically takes four years and includes courses such as medicinal chemistry, pharmacology, and therapeutics. In addition, pharmacy students are required to complete supervised pharmacy practice experiences throughout the program and spend the final year of school in a variety of experiential clinical rotations.
To become licensed, pharmacy school graduates must pass the North American Pharmacist Licensure Exam (NAPLEX), as well as a state jurisprudence exam. Approximately 25-30% of pharmacy graduates pursue post-graduate training, typically in the form of residency and/or fellowship training lasting 1 – 3 years. According to McElhaney, et al. this additional training enables pharmacists to develop leadership skills, improve patient-centered care, refine problem-solving strategies, and advance the growth of their clinical judgement, and these are all important skills needed for advanced clinical pharmacy practice roles.
Benefits of Collaboration
Pharmacists participate in a wide range of activities that enhance the patient care efforts of NPs. They identify and help NPs address medication-related problems, such as drug interactions or adverse medication effects. Specifically, in our review of studies conducted in the telehealth setting, pharmacists helped NPs optimize medication regimens by simplifying complex medication regimens. Additionally, they offer tailored medication recommendations, reduced risk of medication errors, and improved, and improved access to necessary medications.
Clearly given the complementary expertise of NPs and pharmacists, patient care is enhanced when these professions work together as a team. The review underscores the profound impact that effective collaboration between nurse practitioners (NPs) and pharmacists can have on patient care. This partnership has been shown to significantly enhance medication adherence, ensuring that patients follow prescribed treatment plans for better health outcomes.
Collaboration also improves the management of chronic diseases, such as hypertension and diabetes, through shared expertise and coordinated care strategies. By working together, NPs and pharmacists address complex medical needs more efficiently and effectively. Additionally, the streamlined handling of administrative processes, such as medication refills and prior authorizations, reduces delays and barriers to care, allowing patients to access treatments more quickly.
These combined collaborative efforts contribute to higher levels of patient satisfaction and engagement, as individuals feel more supported and involved in their healthcare journey. This review highlights the transformative potential of NP-pharmacist collaboration in advancing care delivery.
Collaborative Models
The review identifies three key models of collaboration between nurse practitioners (NPs) and pharmacists in telehealth settings, each with distinct approaches to teamwork and communication.
The Integrated Collaboration model emphasizes close, real-time interaction. In this approach, NPs and pharmacists work together synchronously through live video or other real-time communication methods, fostering dynamic and immediate decision-making to optimize patient care. This has been found to be the most interactive form of collaboration in which there is direct communication between NPs and pharmacists.
In the Consultation model, pharmacists offer valuable insights to NPs on an as-needed basis, providing recommendations through telehealth platforms or electronic medical records. This model allows pharmacists to lend their expertise when specific medication-related questions or challenges arise, enhancing the care process while maintaining flexibility.
Finally, the Parallel Processes model involves NPs and pharmacists working independently while aligning their efforts through shared medical records. Though their interactions are indirect, this approach ensures coordinated care by keeping both parties informed of each other’s contributions and maintaining a unified focus on the patient’s well-being.
Each model offers unique advantages, catering to different telehealth settings and the specific needs of healthcare teams and those in their care.
Preparing Future Healthcare Leaders
These findings underscore the importance of preparing future NP’s with skills to effectively collaborate with pharmacists and other members of the interprofessional team. While all health professions accreditation standards require interprofessional education (IPE) in curricula, the design and quality of those experiences varies. It is crucial that IPE includes hands-on interprofessional simulation as well as interprofessional clinical experiences designed to help students develop effective communication and teamwork skills that enable acquisition of interprofessional collaborative practice competencies.
Call to Action
This review serves as a guide for future health care innovation and collaboration. Health profession educators, administrators and policymakers should prioritize funding of collaborative practice models to maximize the benefits of interprofessional care provided by NPs and pharmacists. By embracing these collaborative practice models, we can build a more connected, efficient, and patient-centered healthcare system.
About the Authors:
Ashley Fenton, DNP, FNP-C, PMHNP-BC, LCSW-C, is an assistant professor at the Johns Hopkins School of Nursing, and is a dual certified family nurse practitioner and psychiatric nurse practitioner as well as a licensed clinical social worker. Dr. Fenton’s research interests include physical health outcomes in individuals with serious mental illness, reverse models of integrated care, telemedicine, interdisciplinary team based care and training of clinical faculty.
Nicole Mollenkopf, , PharmD, MBA, BCPS, BCPPS, is a pharmacist with advanced education and experience in the design of safe medication-use systems. She is the director of interprofessional education at the Johns Hopkins School of Nursing and oversees required and extracurricular interprofessional education experiences for prelicensure and advanced practice nursing students, and part of an interprofessional team that teaches pharmacology to nursing students.