The HealthWise preventive Services Program

Represents an opportu- nity for pharmacists to fulfill an im- portant role in patient care. Although many other health care practitioners are capable of addressing preventive care recommendations, pharmacists are readily accessible to patients and already participate in many patient care activities into which preventive services could easily be incorporated. This case study highlights one setting in which pharmacists can provide such services, though similar pro- grams could easily be designed for incorporation into other settings. For example, in the community phar- macy setting, this program could be modified to provide a review of the USPSTF recommendations for an in- dividual, with referral to other health care providers for all required inter- ventions. Such reviews can provide a benefit in encouraging preventive care and require very few resources.

In a future evaluation of the pre- ventive care program in the ONU HealthWise clinic, a determination of specific cost savings will be benefi- cial in determining the exact worth of pharmacist involvement in this area. Because it is often difficult to determine the cost savings associated with disease prevention, especially in the short-term, literature dealing with the cost of disease can provide an estimation of the potential ben- efit of prevention. For example, the high initial direct costs of treatment associated with myocardial infarc- tion plus subsequent coronary ar- tery bypass graft surgery (estimated at $30,000 per patient in 2002)30 and ischemic stroke (estimated at $15,000–$20,000 per patient in 1990)31 indicate that the appropri- ate use of aspirin recommended through the clinic has the potential to decrease health care spending for both the participant and the insurer by assisting with the prevention of these costly complications. Because of the high cost associated with heart disease and many other diseases, proper prevention and education are expected to lead to a reduction in long-term expenditures.