b'VA Pharmacists Take On Even MoreCritical Roles Because of PandemicFor years, pharmacists working at the VA, as well as the DoD, have had broader scopes of practice than those in the community. The COVID-19 pandemic expanded it even more, with VA pharmacists playing essential roles in identifying, treating and preventing SARS-C0V-2.By Stephen SpotswoodWASHINGTON, DCFor years, clinical pharmacy specialists (CPS) at VA have been on a path of in-As a pharmacy service, of course the creasedresponsibilityandintegrationintopatient[COVID-19] vaccine has changed our care.TheCOVID-19pandemicdrasticallyaccel-erated this, changing how VA pharmacists interactlives. We basically had to set up the with patients both inside and outside the hospital whole [vaccine distribution] operation changes that are unlikely to go away anytime soon. at our facilityPharmacists would Some of this increased role of CPS is due to VA being at the forefront of using pharmacists in patientprepare the vaccine. We also had care.Bymakingthempartofthepatient-alignedpharmacist who would be where the careteam(PACT),thedepartmentensuredthatvaccine was being distributed to the pharmacists had a voice in the day-to-day treatment of patients. VAs existing investments in telehealthnurses . technology were also key, allowing pharmacists toIvan Cephas, PharmDcommunicatewithveteransregularly,evenwhen the veteran, and sometimes the pharmacists, were unable to come to the hospital. failure. But, yes, the pharmacists were definitely there The VA had started pushing telehealth a lot morein support of everything the hospital needed.before the pandemic. Sometime right before [the pan- Accordingtoastudypublishedlastyearin demic began] a special assignment was sent out ask- theJournaloftheAmericanCollegeofClinical ing all of our providers to test their apparatustheirPharmacythatlookedatCPSencountersbefore capabilitiesfortelehealth.Then,lowandbehold,and during the pandemic, not only did PACT CPS here comes the pandemic, explained Ivan Cephas,encounters increase 32% in 2020 and the number of PharmD, chief of pharmacy at the DCVAMC. unique patient encounters increase by 12%, but there Soon VA physicians were having a large portion ofwas a simultaneous decrease in patient cancellations their patient interactions over the phone and online,and no-shows. At the same time, several key metrics and clinical pharmacists were a part of this. tracking medication adherence remained stable even We did see our PACT pharmacist get to increaseduring the height of COVID-19. 1their panels. And we had pharmacists that did a lotDuringthepandemic,asbefore,diabetesand of [telemedicine appointments], Cephas explained.hypertension remained the two most-common condi-We also had to come up with strategies of havingtions pharmacists helped veterans manage. Diabetes some pharmacists to work from home more often, justencounters went from 14,279 in 2019 to 19,588 in in case we had an outbreak at our service and wed2020a 37% increase. Average reductions in A1c have to rotate people. So we didnt have a total servicewere 0.57% in 2019 and 0.58% in 2020.Continued on Page 42 u40'