Summer 2014 Service Learning
During the summer, I completed numerous
service activities at the Unionville Walgreens. Eric Halpern (a young UConn
Alum) was my pharmacy preceptor. The first activity I participated in was
Medication Therapy Management. MTM is a preventative approach to prevent
negative health outcomes. If a patient’s health and adherence issues can be
caught early on, it saves money in the long run and improves patient outcomes.
While at Walgreens I utilized the
computer system Mirixa to perform MTM services. Mirixa is a program that alerts
the pharmacy to possible patient adherence and regimen issues. The pharmacist
then can set up a meeting or make a phone call to the patient to address the
alert. Insurance companies pay pharmacies a nominal fee for completing each
patient case. Mirixa will raise a flag to any type of drug-drug interaction,
inappropriate treatment, and adherence issues. The majority of the cases I
worked on were adherence issues. For example, Mirixa would inform the pharmacy
that a patient hadn’t refilled their medication on time. Meaning, the patient
picked up a one month prescription and it is has been a month since that date
without a refill. This would suggest that the patient isn’t taking their medication
regularly or as prescribed. I would then call the patient and discuss their
medication regimen. These phone calls were both educational and beneficial to
the patients. Patients had a chance to learn what their medications were for
and I had a chance to drive home the importance of adherence. There were
frequent adherence alerts for blood pressure and cholesterol medications. The
most important counseling point I made with these medications is that you don’t
feel different while taking them. However, it is important to be taking your
meds each day to ensure maximal benefits.
While volunteering at Walgreens, I worked
with the pharmacist to come up with case solutions. I discussed ways to help
patients remember to take their medications. Setting reminders in their phones
and using weekly pillboxes were among various solutions discussed. Some cases
were more complicated and I needed the pharmacist’s assistance. For example, there
was a patient who was on transplant medications. Mirixa raised a drug
interaction flag. The patient was on two immunosuppressant drugs, Mycophenolate
and Tacrolimus. With the pharmacist, we looked into this interaction and it
proved to be a minor interaction. Mycophenolates peak levels were slightly
increased when on board with Tacrolimus. Both medications came from the same
doctor’s office. I called the doctor’s office and spoke to them about our
situation and the doctor assured me the patient was being monitored and that
was the correct therapy. The patient had been on this regimen for several
months and had yet to experience any issues.
While volunteering, Eric had me set up
and run blood pressure clinics. I sat at the front of the store and asked
patients if they wanted their blood pressure taken. I took any willing patients
to a private screening room and measured their blood pressure using an
electronic blood pressure monitor cuff. I discussed blood pressure
goals/targets with these patients. Furthermore, I inquired about any
medications there were currently taking and if their doctor was aware of their
blood pressure. When working with these patients, I made sure they were aware
of lifestyle changes that would positively affect their blood pressure. I did
my best to empower my patients and give them the knowledge to make healthy life
decisions.
Eric worked with me on several other
projects. I answered patient inquires at the pharmacy. A patient asked when was
the best time to get the influenza vaccine. The CDC recommends that the
pharmacist start giving the flu vaccine as soon as the vaccine becomes readily
available in their pharmacy. The patient’s concern was if they got the flu shot
in July would the effects of the shot wear off before the end of the flu
season. I called the CDC to ask about this question. I talked to a specialist
who still recommended giving the flu shot as early as possible. He discussed
that only children could receive two flu shots in one season to ensure they
were protected.
During my time at Walgreens, I also
participated in a medication reconciliation meeting with Eric and a patient. An
elderly woman was overwhelmed by all of her medications and had questions for
the pharmacist. One afternoon, Eric and I sat down with her and discussed what
each of her meds was used for. We made recommendations for meds that could be
consolidated to combination dosage forms. Finally we discussed OTC products she
was taking and their efficacy. We helped the patient gain confidence and
control of her therapy. Eric also had me go onto the floor with patients to
answer their OTC medication questions. Several patients came up to the counter
to ask about which pain medication to use and I assisted them with their
decision. Eric quizzed me on OTC products and their active ingredients.
I learned a lot from this experience. I
was able to successfully complete MTM cases and work with patients to improve
their adherence and health. I gained experience working with other health
agencies. I learned on how to research drug related questions. I was beneficial
to the pharmacy because I engaged their patient population. My volunteering
allowed for certain tasks to be conducted that the pharmacist otherwise
wouldn’t have been able to perform.
I would highly recommend Eric Halpern as
a preceptor. He did his upmost best to ensure I wasn’t there to dispense and
fill drugs. I didn’t count out one prescription the entire time I was with
Walgreens. He is very compassionate about pharmacy and is very patient with his
students.