Service Learning in the Community Setting

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.