Clinic Weeks 3-5

Starting week 3 of our rotation, we got some new pharmacy students at the clinic on rotation! We spent the first few days helping orient them to the clinic, our typical daily tasks, and the clinic's technology. We also showed them where the candy drawer is!  

We continued working on our medication reconciliation project that focuses on consolidating patient profiles and making sure the providers in the clinic have the patient's current medications accurately listed in the EHR.  We had lots of opportunity to counsel patients on their prescriptions- we particularly counseled patients with diabetes about their insulin and blood sugar monitoring! 

During week three I had the opportunity to present a formal drug information question response to the Pediatric Committee consisting of doctors, nurse practitioners, and nurses. My response was to a question about the evidence for alternating ibuprofen and acetaminophen in the pediatric population. 

We also traveled to the Riverton clinic in week three to get more hands-on experience with patients in a different clinic. At the Riverton clinic we were able to visit with multiple patients with complex medication regimens. We spent two days at the Riverton clinic seeing patients with a multitude of disease states: high blood pressure, high cholesterol, diabetes, COPD, asthma, anxiety, depression, alcohol and/or drug abuse, and dermatologic conditions. We were able to review the patients' charts and prepare before entering the patients' rooms with the providers to talk with the patient about their disease states, medications, and any concerns they were having. During these visits we assessed disease control based on labs and vital signs, reviewed the patient's medication regimens and inquired about side effects, made pharmacologic and nonpharmacologic recommendations for the patients, and even recommended vaccines. 

During week four we spent our time at the Arapahoe clinic helping review the charts of the patients coming to clinic that day. We brought suggestions for medication changes (like adding metformin for  patient with diabetes) or necessary vaccines (a patient whose last tetanus shot was over 10 years ago) to our preceptor Katherine. Reviewing these charts helped us see a variety of disease states and age groups and helped us stay up to date on disease management guidelines as well as vaccine schedules. 

We also attended the WY Joint Labor, Health, and Social Services Committee Meeting. This was a cool, unique opportunity to hear about the costs of healthcare in WY- specifically the committee was considering the pros and cons of PBMs on WY healthcare. We were able to hear from multiple speakers such as PBM lobbyists, pharmacists, and independent pharmacy owners. 

Every other week at the clinic, the Controlled Substance Committee meets to discuss any high-risk patients possibly needing special attention. As students we were given specific patients to look into and present on at the bi-weekly committee meeting. All our patients were either prescribed controlled substances inappropriately or taking their controlled substances inappropriately. We presented on what the problem was, why was it a problem, and made recommendations on how to fix the problem. Over our rotation, we saw some of our patients problems resolved and consistently checked their charts for any updates.