Getting it "just right"“Medication regimen assessment” helps HMG patients and providers, alike.
There are a few things in life that you can’t afford to have, “almost right.” Medications are one of them. They’ve got to be just right. Variance, even slight, can be detrimental—if not deadly. Yet, pharmaceutical advances, marketed directly to the consumer, are shot from the barrel at a bewildering speed. “When I graduated from med school, I had a wonderful mentor who told me, ‘Jerry, I want you to know six drugs. Six basic drugs are all you need to treat patients,” quips HMG Founder & President Jerry L. Miller, MD. “Today, there are 26 that begin with the letter ‘Z’. There are 720 new drugs in the pipeline.” According to Dr. Miller, pharmacists are one of the “most under-utilized resources for focused patient & provider education as well as collaborative management of some chronic diseases.” “They’re highly-knowledgeable of the efficiencies, efficacies, interactions and reactions of drugs,” begins Dr. Miller. “And, they’re an integral component of a multi-disciplinary approach to education and chronic care management.” Through HMG’s collaborative relationship with the University of Tennessee College of Pharmacy, HMG co-funds three academic pharmacy clinicians (L. Brian Cross, Pharm.D., CDE; Benjamin Gross, Pharm.D.; and Joni Foard, Pharm.D., CDE). Together, they not only help to manage multiple HMG specialty clinics (anticoagulation, lipids, diabetes management, etc.), they also provide a service called “medication regimen assessment.” HMG’s L. Brian Cross, Pharm.D., CDE, says the medication regimen assessment service emphasizes the Pharm.D.s’ role within HMG as that of a “physician advocate.” “Our goal is to support our HMG providers by working directly with them and their most difficult-to-manage patients,” begins Dr. Cross. “We’re a part of the physician’s team. When they have a patient with a really difficult medication regimen, we’re a great resource to put another set of eyes on a regimen and look at it from a patient-specific therapeutic perspective.” Here’s how the service works. Say an HMG physician has a patient who sees multiple specialists and is on more than a dozen different medications. The HMG primary care provider can refer the patient for limited visits with an HMG Pharm.D. for medication regimen assessment. “We basically offer a ‘tune up’ and then promptly send the patient back to their PCP for continued care. Our focus is solely on that of working with the provider to improve a patient’s medication regimen,” says Dr. Cross. The first visit typically involves an hour of counseling and medication review. Patients are instructed to bring in every single product they take—over-the-counter medications, prescriptions products, vitamins, natural medicines, herbal products and homeopathic items—containers and all. “More often than not, we’ll have a patient bring in a bag of 20 to 40 different products—quite a stock pile, many of them of their own choosing,” explains Dr. Cross. “To make matters worse, we find that most are not even taking their prescribed medications according to their doctor’s orders.” Recent studies suggest that as many as 1/3 of all hospital admissions and/or ER visits are secondary to medication-related issues. In addition, it has been shown that adherence to certain chronic medications for things such as hypertension and hyperlipidemia is a direct predictor of improved clinical outcomes such as heart attacks and strokes. HMG’s Dr. Warren Jones calls the services of the HMG Pharm.D.s’ a “very good resource,” applauding their patient education efforts. “They’ve been an incredible help to me, streamlining medications and providing great patient education and information,” says Dr. Jones. For the patient, a return visit to the Pharm.D. may involve medication counseling and education regarding the importance of adhering to prescribed medication instructions. “We’re a medication-advocate, pharmaceutical-consultant and physician-extender all wrapped up in one,” says Dr. Cross. “We’re therapeutic managers, not diagnosticians. When we identify a medication regimen that could be improved, we first consult with the patient’s HMG provider for approval.” “This service has been a great resource for me,” says HMG primary care provider Emily Morawski, MD. “Often, I don’t have time to sit down with the patient and go through each medicine with them and look at the different interactions and side-effects.” Dr. Morawski says she most often utilizes the medication regimen assessment service for her patients who are on multiple medications (generally more than ten), most often related to diabetes. Both Drs. Jones and Morawski agree that the Pharm.D. resource provides great reassurance. Both Drs. Jones and Morawski agree that the Pharm.D. resource provides great reassurance. For more information concerning HMG’s medication regimen assessment service, contact Dr. Brian Cross at 423-578-1586. |