Chronic Disease Management Service Opportunities for Community Pharmacists During the COVID-19 Pandemic

Gregory Dwyer, MPH; Adebola Popoola, JD, MPH, MBS; Naomi Seiler, JD; Nicole Therrien, PharmD, MPH; Aaron Karacuschansky, MPH; Erika Fulmer, MHA; Katie Horton, JD, RN, MPH


Prev Chronic Dis. 2022;19(3):e10 

In This Article


All pharmacy-associated interviewees highlighted the lack of payment models to reimburse community pharmacists for chronic disease management as a barrier to community pharmacist provision of chronic disease management services. One pharmacist interviewee noted that, historically, pharmacists have provided chronic disease management services in an informal capacity without reimbursement. This arrangement was more feasible when pharmacy profits from other services, including dispensing, were more profitable, but as brick-and-mortar pharmacy profits have decreased,[4] pharmacies have less capacity to provide services for which they do not receive reimbursement. Additionally, interviewees noted that pharmacists, particularly those working in rural areas, might be short-staffed or working alone and lack capacity to simultaneously fill prescriptions, administer vaccinations, and provide services related to chronic disease management such as medication therapy review and lifestyle and medication counseling.

Another interviewee stressed the need for community pharmacists to identify services that, given their education and skill set, they are exceptionally positioned to provide. Caring for patients who have multiple, complicated conditions and who are taking multiple medications with potential interactions is a role for which pharmacists are uniquely trained. The interviewee emphasized the importance of pharmacists focusing on the expertise they offer to chronic disease management to serve as valuable members of care teams.

Several interviewees noted that incorporating chronic disease management services and additional immunizations (including those for COVID-19) into the community pharmacy workflow may be challenging for some pharmacies due to lack of staffing and resources. Some pharmacies have made progress in improving practice workflow through medication synchronization, as well as the development of platforms to identify patients with chronic diseases and to guide pharmacists in providing chronic disease management services. Other innovations in practice infrastructure, such as use of centralized prescription processing facilities, have also been effective at allowing pharmacists to spend more time caring for patients who have chronic diseases.