Pharmacist Burnout: Recognition and Action Are Needed

Abstract

View Large Image Figure ViewerDownload Hi-res image Download (PPT)According to the U.S. Centers for Disease Control and Prevention, 45.8% of all Americans and 85% of those older than 60 use prescription medications (NCHS Data Brief 2019;334:1–8). Pharmacists have the responsibility to ensure that these Americans who rely on medications are achieving their health-related goals safely. This responsibility has put pharmacists on the front line in any health emergency, including the COVID-19 pandemic.Throughout the pandemic pharmacists have sometimes taken on unfamiliar roles to meet new challenges, such as supplying chronic medications without a prescription, and they have taken on the additional burden of educating the community on vaccination and infection control (J Am Pharm Assoc [2003] 2021;61[2]:E61–E64). These essential tasks safeguard the well-being of many; however, as with other professions in health care, being responsible for the care of others in demanding circumstances exposes pharmacists to a greater risk of stress and burnout.We will highlight what is known about the pharmacist workforce with respect to burnout and the actions that need to be taken to ensure the welfare of these practitioners and the patients they care for.Burnout Across PlatformsFor pharmacists, the risk of burnout varies across the multiple practice settings where pharmacists work. Pharmacists embedded in retail pharmacies have been providing care to an anxious community worried about the pandemic and medication supply, while they also have juggled immunization mandates and outreach. Furthermore, health system pharmacists have been key in managing medication shortages and vaccine programs, as well as training and supporting hospitals with dynamic medication management programs.Ambulatory care pharmacists have been learning how to deliver care via telehealth platforms while trying to ensure that they will be reimbursed and recognized for their services. Pharmacists within long-term care have been challenged to sustain access to the residents and facilities to conduct medication reviews and medication administration/management inspections. Additionally, some of these same pharmacists have also been teaching and conducting research, where again they are navigating new modalities of delivery.This has all been happening as new guidance and mandates have been coming rapidly at every team member on how best to manage COVID-19 and coexisting comorbidities, and while pharmacists were juggling personal stressors and loss of loved ones and peers.Research to DateStudies on pharmacist burnout, which predate the pandemic, indicate that it is likely to occur at rates that are similar to physician burnout. This is estimated at around 50%, though community pharmacist burnout has been reported in as many as 75% of study participants (J Am Pharm Assoc [2003] 2021;61[2]:145–150). For health system pharmacists, 52.3% had a high score of burnout on at least one domain of the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a burnout assessment tool (Am J Health Syst Pharm 2018;75[23, suppl. 4]:S93–S100).Burnout in these studies was linked to demanding workloads with limited time and to inefficiencies in practice. The top reasons cited by pharmacists for their lack of time have been inadequate staffing and performing administrative tasks such as prior authorization requests and phone calls (Covermymeds Insights, Dec. 20, 2021: https://bit.ly/36Vdid6).Though burnout has yet to be rigorously studied in the context of COVID-19, based on the expansion of pharmacist duties and roles that has accompanied the pandemic it is reasonable to surmise that pharmacist burnout may be occurring at a higher rate now than had been previously reported.Steps to Reduce BurnoutTo combat burnout and help rebuild joy in the workplace it is critical to:•Identify burnout as well as increase resiliency through professional education, training, counseling, and support.•Increase accessibility to health information related to patient care, which would increase work efficiency.•Increase the scope of practice to assist with emergency preparedness and health promotion so pharmacists can help people more directly.•Increase the pharmacist workforce so that the demanding workload is distributed among more qualified professionals.Although these steps may help reduce burnout among pharmacists, additional rigorous research is needed. This research should develop tools to measure both burnout and strain — such as by scoring the impact of workplace stressors on the body as well as evaluating which interventions are effective (Am J Pharm Educ 2022;86:ajpe8616).Pharmacists also need to continue to be recognized and reimbursed for their important role on the health care team. This is especially important given their expanding role as they continue to meet the care needs of their community in the setting of a global pandemic and at the level of individual patients.Dr. Brandt is a professor in the Department of Pharmacy Practice and Science (PPS) and executive director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy.Dr. Lee is the Geriatric Pharmacotherapy Fellow at the Peter Lamy Center on Drug Therapy and Aging at University of Maryland Baltimore. Additionally, he works as a clinical pharmacist at the MedStar Center for Successful Aging. According to the U.S. Centers for Disease Control and Prevention, 45.8% of all Americans and 85% of those older than 60 use prescription medications (NCHS Data Brief 2019;334:1–8). Pharmacists have the responsibility to ensure that these Americans who rely on medications are achieving their health-related goals safely. This responsibility has put pharmacists on the front line in any health emergency, including the COVID-19 pandemic. Throughout the pandemic pharmacists have sometimes taken on unfamiliar roles to meet new challenges, such as supplying chronic medications without a prescription, and they have taken on the additional burden of educating the community on vaccination and infection control (J Am Pharm Assoc [2003] 2021;61[2]:E61–E64). These essential tasks safeguard the well-being of many; however, as with other professions in health care, being responsible for the care of others in demanding circumstances exposes pharmacists to a greater risk of stress and burnout. We will highlight what is known about the pharmacist workforce with respect to burnout and the actions that need to be taken to ensure the welfare of these practitioners and the patients they care for. Burnout Across PlatformsFor pharmacists, the risk of burnout varies across the multiple practice settings where pharmacists work. Pharmacists embedded in retail pharmacies have been providing care to an anxious community worried about the pandemic and medication supply, while they also have juggled immunization mandates and outreach. Furthermore, health system pharmacists have been key in managing medication shortages and vaccine programs, as well as training and supporting hospitals with dynamic medication management programs.Ambulatory care pharmacists have been learning how to deliver care via telehealth platforms while trying to ensure that they will be reimbursed and recognized for their services. Pharmacists within long-term care have been challenged to sustain access to the residents and facilities to conduct medication reviews and medication administration/management inspections. Additionally, some of these same pharmacists have also been teaching and conducting research, where again they are navigating new modalities of delivery.This has all been happening as new guidance and mandates have been coming rapidly at every team member on how best to manage COVID-19 and coexisting comorbidities, and while pharmacists were juggling personal stressors and loss of loved ones and peers. For pharmacists, the risk of burnout varies across the multiple practice settings where pharmacists work. Pharmacists embedded in retail pharmacies have been providing care to an anxious community worried about the pandemic and medication supply, while they also have juggled immunization mandates and outreach. Furthermore, health system pharmacists have been key in managing medication shortages and vaccine programs, as well as training and supporting hospitals with dynamic medication management programs. Ambulatory care pharmacists have been learning how to deliver care via telehealth platforms while trying to ensure that they will be reimbursed and recognized for their services. Pharmacists within long-term care have been challenged to sustain access to the residents and facilities to conduct medication reviews and medication administration/management inspections. Additionally, some of these same pharmacists have also been teaching and conducting research, where again they are navigating new modalities of delivery. This has all been happening as new guidance and mandates have been coming rapidly at every team member on how best to manage COVID-19 and coexisting comorbidities, and while pharmacists were juggling personal stressors and loss of loved ones and peers. Research to DateStudies on pharmacist burnout, which predate the pandemic, indicate that it is likely to occur at rates that are similar to physician burnout. This is estimated at around 50%, though community pharmacist burnout has been reported in as many as 75% of study participants (J Am Pharm Assoc [2003] 2021;61[2]:145–150). For health system pharmacists, 52.3% had a high score of burnout on at least one domain of the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a burnout assessment tool (Am J Health Syst Pharm 2018;75[23, suppl. 4]:S93–S100).Burnout in these studies was linked to demanding workloads with limited time and to inefficiencies in practice. The top reasons cited by pharmacists for their lack of time have been inadequate staffing and performing administrative tasks such as prior authorization requests and phone calls (Covermymeds Insights, Dec. 20, 2021: https://bit.ly/36Vdid6).Though burnout has yet to be rigorously studied in the context of COVID-19, based on the expansion of pharmacist duties and roles that has accompanied the pandemic it is reasonable to surmise that pharmacist burnout may be occurring at a higher rate now than had been previously reported. Studies on pharmacist burnout, which predate the pandemic, indicate that it is likely to occur at rates that are similar to physician burnout. This is estimated at around 50%, though community pharmacist burnout has been reported in as many as 75% of study participants (J Am Pharm Assoc [2003] 2021;61[2]:145–150). For health system pharmacists, 52.3% had a high score of burnout on at least one domain of the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a burnout assessment tool (Am J Health Syst Pharm 2018;75[23, suppl. 4]:S93–S100). Burnout in these studies was linked to demanding workloads with limited time and to inefficiencies in practice. The top reasons cited by pharmacists for their lack of time have been inadequate staffing and performing administrative tasks such as prior authorization requests and phone calls (Covermymeds Insights, Dec. 20, 2021: https://bit.ly/36Vdid6). Though burnout has yet to be rigorously studied in the context of COVID-19, based on the expansion of pharmacist duties and roles that has accompanied the pandemic it is reasonable to surmise that pharmacist burnout may be occurring at a higher rate now than had been previously reported. Steps to Reduce BurnoutTo combat burnout and help rebuild joy in the workplace it is critical to:•Identify burnout as well as increase resiliency through professional education, training, counseling, and support.•Increase accessibility to health information related to patient care, which would increase work efficiency.•Increase the scope of practice to assist with emergency preparedness and health promotion so pharmacists can help people more directly.•Increase the pharmacist workforce so that the demanding workload is distributed among more qualified professionals.Although these steps may help reduce burnout among pharmacists, additional rigorous research is needed. This research should develop tools to measure both burnout and strain — such as by scoring the impact of workplace stressors on the body as well as evaluating which interventions are effective (Am J Pharm Educ 2022;86:ajpe8616).Pharmacists also need to continue to be recognized and reimbursed for their important role on the health care team. This is especially important given their expanding role as they continue to meet the care needs of their community in the setting of a global pandemic and at the level of individual patients.Dr. Brandt is a professor in the Department of Pharmacy Practice and Science (PPS) and executive director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy.Dr. Lee is the Geriatric Pharmacotherapy Fellow at the Peter Lamy Center on Drug Therapy and Aging at University of Maryland Baltimore. Additionally, he works as a clinical pharmacist at the MedStar Center for Successful Aging. To combat burnout and help rebuild joy in the workplace it is critical to:•Identify burnout as well as increase resiliency through professional education, training, counseling, and support.•Increase accessibility to health information related to patient care, which would increase work efficiency.•Increase the scope of practice to assist with emergency preparedness and health promotion so pharmacists can help people more directly.•Increase the pharmacist workforce so that the demanding workload is distributed among more qualified professionals. Although these steps may help reduce burnout among pharmacists, additional rigorous research is needed. This research should develop tools to measure both burnout and strain — such as by scoring the impact of workplace stressors on the body as well as evaluating which interventions are effective (Am J Pharm Educ 2022;86:ajpe8616). Pharmacists also need to continue to be recognized and reimbursed for their important role on the health care team. This is especially important given their expanding role as they continue to meet the care needs of their community in the setting of a global pandemic and at the level of individual patients. Dr. Brandt is a professor in the Department of Pharmacy Practice and Science (PPS) and executive director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy. Dr. Lee is the Geriatric Pharmacotherapy Fellow at the Peter Lamy Center on Drug Therapy and Aging at University of Maryland Baltimore. Additionally, he works as a clinical pharmacist at the MedStar Center for Successful Aging.