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New Pharmacotherapy Clinic Serves Chronic Conditions

Hospital becomes one of the first to develop innovative pharmacist-led clinic

When patients are given a diagnosis of inflammatory bowel disease and placed on medication therapy, they often leave their doctor's office with as many questions as answers.

Newer specialty medications can be costly and come with unique side effects—and most patients need more education about their condition and the prescribed therapy than is possible during a standard doctor's visit.

Enter St. Jude Medical Center's new Pharmacotherapy and Medication Management Clinic.

Located inside the Knott Family Endoscopy Center, the clinic focuses on patients with a chronic gastrointestinal condition—primarily Crohn's disease, ulcerative colitis and hepatitis C—who could benefit from one-on-one education and support from a pharmacist. While the clinic launched in September with a single-specialty emphasis, over the next few months additional specialties and diagnoses will be added, starting with rheumatology and oncology.

First appointments are typically an hour, during which the clinic's pharmacist reviews each of the patient's current medications and walks them through their treatment plan—all while educating about side effects and probing for issues that might affect medication adherence. "It's not uncommon for patients to arrive with a bag full of prescriptions," says Kim Vo, Pharm D, BCACP, a faculty member of the Marshall B. Ketchum School of Pharmacy who joined St. Jude last March. "We're looking at the whole picture, not just are all their medications safe, effective or even necessary, but do they have the knowledge to actively participate in improving their own health."

Follow-up appointments and regular phone calls allow the pharmacist to assess the patient's response to treatment and provide closer monitoring—and patients are encouraged to call or visit the clinic whenever needed. iPads have been ordered for patients who have mobility issues to check-out and take home, allowing face-to-face conversations with the pharmacist.

"Because we can see these patients more often than a busy GI practice typically can, we can serve as the 'eyes' of the physician in identifying issues early," explains Kim, who is board certified in ambulatory care pharmacy. Constant communication with the GI specialists regarding patient updates and concerns allows the clinic to facilitate better outcomes while also bridging any gaps or transitions in care.

Eugene Yoon, MD, Medical Director of St. Jude's Comprehensive Digestive Health Services, says the clinic benefits patients and physicians alike. "Patients feel more secure in their treatment and more confident in their ability to navigate it," explains Dr. Yoon, who refers all of his IBD patients to the clinic and says patient reviews have been high. "The education, monitoring and trust created through this ongoing relationship with a pharmacist adds a valuable dimension to their care."

The clinic is also focused on reducing costs for patients, working with insurance companies, manufacturers and financial assistance programs to make medication therapy more affordable – while relieving physician's offices of the time-consuming burden of documentation and approvals required by health plans.

"By handling the paperwork and coordination with specialty pharmacies and insurance companies, we free up our physician's offices to focus on patient care, while also improving affordability, access and convenience for the patient," explains Don Miller, Director of Pharmacy Services. "Our specialty practices are often inundated and we believe the clinic's innovative approach can help extend and enhance the clinical excellence they offer patients."

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