Interview with Susan Peppers

Gary Barg: Susan, we always tell attendees at our Fearless Caregiver Conferences that one of the most important and sometimes most underutilized partnerships they can have as caregivers is with their and their loved one’s pharmacist. Can you tell me why caregivers should be engaged with pharmacists to help provide coordinated care for their loved ones? 

Susan Peppers:  Pharmacists really have two important roles to play with caregivers. The first is ensuring safety in medication dispensing, making sure that there are no issues associated with drug interactions or high-risk medications, particular in the elderly. It is really important to make sure that your loved one has the right medication for them, and that there are no side effects or potential drug interactions.

The other important role is the most overlooked and that is as a source of primary healthcare information, especially if you think about the role that COVID has played over the last 18 months and the amount of medical information and questions that patients and caregivers have about how to keep themselves safe and healthy. Patients or caregivers may be reluctant to go to the doctor’s office or to an emergency room and may be seeking alternative sources of trusted information.

• Should my loved one get a vaccination?
• When should they get a vaccination?
• Which is the most appropriate vaccination for them to receive?
• Are there interactions with the medications and the vaccination?
• Or even just day-to-day questions about my loved one missing a dose.

Pharmacists are at the ready to answer any and all of those questions that caregivers may have, and they’re a frontline healthcare provider and accessible to everyone.

Gary Barg: I love the phrase, they’re a frontline healthcare provider because a lot of times, we don’t see that. In fact, what can go wrong if a person doesn’t involve a pharmacist into their loved one care team? And on the flipside, how can it improve the outcomes? 

Susan Peppers: I think something that’s on so many patients’ and caregivers’ minds today is the cost of medications. As a result of that, you may be getting medications from several different pharmacies. You may be getting some generic medications from one pharmacy and leveraging home-delivery pharmacies for other medications. As a result, your pharmacist may not have a complete picture of all of the medication that you or your loved one is taking. That could lead to significant risks associated either with not taking the right therapy or drug interactions. We know that many elderly patient's medication combinations may cause dizziness or drowsiness that may lead to falls. 

For that reason, it really is important, even if you don’t purchase all of the medications from the same pharmacy, which is what we recommend, to at least develop a relationship with a pharmacist that you trust and provide them with a full picture of all of those medications and ask for information and guidance about what might be missing, what might be combinations or interactions that you want to look out for. And what side effects should you be aware of to be on the lookout for in case you see developing in your loved one that you would want to raise to your healthcare provider. 

Gary Barg: There are so many ways to interact now. Telehealth has become an accepted way for us to interact with our primary care providers. I think my mom now has more telehealth appointments than in-person. Now, with the Delta Covid variant surging and the flu season coming on us, is there a similar way that caregivers can interact with their pharmacist? 

Susan Peppers: Many pharmacies now have web chat, or they may have a video appointment available where you can interact with your pharmacist in the privacy of your own home when it’s convenient for you. No matter what your questions; if it’s 11 o’clock at night and your loved one is dizzy or has had a fall or you have a question about some loose tablets on the counter. There’s always a way to reach a pharmacist on the phone and spend time in the privacy of your own home and ask those questions.

Gary Barg: Is there a way for a family caregiver to interact directly with the Express Scripts pharmacist?

Susan Peppers: Absolutely. At the Express Scripts pharmacy, we have pharmacists available 24 hours a day, 365 days a year, and that’s so important for caregivers. In our pharmacy systems, we have the ability for our patients to list their authorized caregivers, and we authenticate and make sure that the person who’s calling has the privacy rights to discuss that patient’s care. It is so heartwarming for our pharmacists to receive caregiver testimonials when a caregiver says something like, “You don’t know how much this has put my mind at ease just to have the information.” 

Something that we like to tell our patients is that the medications or the vaccinations you don’t take, are as important and impactful as those you do. So when you have an omission of something important like a flu shot, it really can impact your health in a significant way. 

Gary Barg: And do feel comfortable when you go up to the counter to say, “Hey, I’d like to speak to the pharmacist. I have some questions.” Anytime I’ve ever done that, the responses I’ve gotten have been professional, warm and courteous.

Susan Peppers: I’m so glad to hear that. As pharmacists, the thing that we love to do the most is take care of patients and provide information that’s helpful to family members and caregivers. And so if I had my choice between counting pills and putting them in a bottle or talking to a patient and providing care, I’d much rather provide care to a patients. And know that when you go to the pharmacy, you have the ability to ask for a private consultation if you’re not comfortable having the conversation at the counter. At Express Scripts Pharmacy, you could always call on the phone and have that conversation when it’s convenient for you. And at anytime if there’s an emergency situation where you need some help or support.

Gary Barg: This is a conversation we’ve been having with family caregivers for decades and hope to keep having because we so very much believe in the importance of this particular healthcare partnership for the caregiver, for their own health, and for the people they care for. 

Susan Peppers: The one thing I’ve noticed with my own parents, who are both 90 years old and still living on their own, thankfully is my role is as a trusted advisor to them as a daughter and a pharmacist. Understanding the why behind them needing to take their medications is incredibly important, that simply putting it out for them or telling them they need to take it or it’s important to take the medication often isn’t enough. Particularly with my mom, who doesn’t like to take medications. Yet, explaining to her how it works and why it’s important to keep her healthy makes a huge difference in her acceptance of taking that medication. And that’s information pharmacists can provide to you in order to help understand how you can approach your loved one to make sure that they’re taking their medications appropriately.  

Gary Barg: It’s a partnership. They’ve become a partner in helping you care for your loved ones. 

Susan Peppers: And the other thing that I think is really important is that every caregiver and patient situation is different. There are different needs. Some patients may need pill reminders or dose reminders or technology to help support medication adherence. Some patients and caregivers may just need information and support. And the thing that’s really great about pharmacists is that they have that knowledge to be able to customize their advice based upon that individual patient and family situation because no two situations are the same. 

Gary Barg: Once you see one family caregiving situation, you’ve seen one family caregiving situation. 

Susan Peppers: That’s exactly right. And as great as all of the variety of products and technologies are that are on the market, you have to understand what does each one offer and which one is the right one for your particular situation. 

Gary Barg: Susan, what’s the one most important piece of advice you’d like to share with family caregivers? 

Susan Peppers: Just don’t underestimate the value of the pharmacist as a part of your healthcare support team. We’re here to answer questions. We’re here to help you triage when a problem happens. We’re here as part of your primary healthcare team. And I just would want to leave caregivers with that message that we’re here 24 hours a day to help support making your life easier in caring for your loved ones.