Prepared by a Task Force of the AES Council on Clinical Activities:
- Timothy Welty, PharmD, College of Pharmacy and Health Sciences, Drake University, Des Moines, IA
- Jon Cokley, PharmD, Texas Childrens Hospital, Houston, TX
- Barry Gidal, PharmD, School of Pharmacy, University of Wisconsin, Madison, WI
Reviewed by the AES Treatments Committee and approved by the committee and the AES Council on Clinical Activities.
These suggestions are provided to help in management of patients with epilepsy by better engagement of a pharmacist in the care team.
- Most states allow for physicians, and in some cases other prescribers (e.g., Advance Practice Providers), to enter into a collaborative practice agreement with a pharmacist. Under the terms of these agreements, a pharmacist may be able to adjust doses of medications, discontinue medications, approve refills of medications, order laboratory tests for monitoring, and initiate alternative medications. Effective use of collaborative practice agreements with pharmacists can reduce practice burden and increase patient access to care.
- Pharmacists in several states are able to administer point of care testing (e.g., influenza testing, strep throat, temperature checks, glucose monitoring) and in some cases initiate treatment for positive tests. These are important resources for patients to utilize, reducing practice burden. (It is unclear at this point in time if pharmacists will be able to administer COVID-19 point of care testing. However, many pharmacists are ready to administer COVID-19 point of care testing, should these tests be available.)
- Pharmacists are an effective resource in triaging patients to appropriate care. They can help in screening patients for possible symptoms (e.g., measuring temperature) and directing patients with new upper respiratory infection symptoms and fever to the appropriate medical provider. Additionally, pharmacists can help in managing patients seeking unnecessary urgent or emergency care for issues like medication-related problems.
- Pharmacists are able to provide immunizations in individuals down to 6 years of age in essentially all states. While a vaccination for COVID-19 is not currently available, it is important for patients to have all vaccinations up to date. (If a COVID-19 vaccination becomes available, pharmacists will be able to administer this vaccination.) Patients can be referred to the local pharmacist for ensuring immunizations are current.
- Some models of telehealth have effectively used pharmacists in the delivery of telehealth to patients with epilepsy. Pharmacists can be used to assist in working with patients in telehealth.
- Inclusion of a pharmacist in the determination of possible alternative antiseizure medication (ASM), should medication shortages occur, and in the development of seizure rescue plans brings an understanding of the patient’s overall medication history and enables the pharmacist to assist in implementation of these plans should a plan need to be used.