PHARMACISTS AS AGENTS OF CHANGE FOR RATIONAL DRUG-THERAPY

We analyze what is known and unknown about the contribution of the pha rmacist as patient educator, physician consultant, and agent to affect patient outcomes in ambulatory settings, The need for pharmacist serv ices is discussed, as are the theoretical underpinnings and quality of the scientific evidence to support their efficacy. The analysis is co nducted in the context of a shift in pharmacists' roles from product t o patient orientation as well as recent U.S. legislation mandating enh anced pharmacists' roles via drug utilization review for all Medicaid patients. We conclude with a research and action agenda, calling for s tronger research designs in evaluating pharmacists' interventions. The shifting paradigm in the pharmacy profession, coupled with the implem entation of the Omnibus Budget Reconciliation Act of 1990, provide uni que opportunities for rigorous evaluations of pharmacists as agents of change for rational drug therapy.