CLINICAL PHARMACIST INTEGRATION INTO FAMILY PRACTICE

Jason Min and Larry Leung, B.Sc.(Pharm.), RPh

Clinical Pharmacists | Directors | Clinicare Pharmacists Inc.

Lecturers | Faculty of Pharmaceutical Sciences, UBC

Jason.Min@ubc.ca | Larry.Leung@ubc.ca

Program Overview

• Clinical Pharmacist working collaboratively with family Physicians since 2012

• Family practice clinics in Vancouver

• Goals: 1. Enhance the level of care provided to patients with clinical pharmacist

support

2. Develop opportunities for unique experiential learning for health professional students

Assessment of

presenting complaint

Medication history

Interpret Lab

values

Order and interpret

Lab values

Make diagnosis

Pharmacist relies on the

correct/working diagnosis

Plan treatment options for

medications

Plan treatment

options

Flow Sheet for Collaboration between Pharmacist (left side) and Physician (right side)

Flow Sheet for Collaboration between Pharmacist (left side) and Physician (right side)

Initiate treatment

plan

Initiate medication treatment

plan

Patient education

Patient education

Monitor response

to treatment

Monitor response to medication treatment

Resolution or chronic disease

management

Resolution or chronic disease

management

Model of Care

Patient

Physician

Pharmacist

Family Specialists

Other Clinicians

Services Provided

We work at the desired level of collaboration with each Physician

• Complex Medication Management • Natural Health Product and Non-Prescription Management • Diabetes Management • Cardiovascular Disease Management • Osteoporosis & Falls Prevention Management • Asthma/COPD Management • Pain Management • Smoking Cessation Program • Sleep Hygiene and Management • Palliative Care

Pharmacist Appointment Types

1. 30 - 60 min Pharmacist visit only

1. 30 – 60 min Pharmacist visit followed by a Physician visit

2. Pharmacist follow-up by phone or in-person

Pharmacist Appointments

• Each Physician receives: • Medication reconciliation and EMR update

• Completion of CDM flow sheets

• Recommendations to the Physician

• Academic detailing to team

• Drug information services

• Each patient receives: • Medication reconciliation and medication review

• Medication and disease education

• Monitor and support compliance

• A review of blood work

• An opportunity to get refills and lab requisitions

Referral to Pharmacist

• Criteria: • ANY patient on at least 1 medication

• Best candidates: • CDM

• Patients who need greater education on disease or medications

• Patients with medication or supplement-related questions

• Other suspected medication-related issues

Patient Feedback

“I'm so glad you're a part of my team….(after speaking with you) it is such a relief to have the two medication options and know how to safely use them! Thanks so much for all your expertise!”

“I just want to say how incredibly impressed I am with this service. He has followed up with me consistently every week and

it has really helped me knowing that someone is following through with my care. I am officially off opiates now!”

Physician Feedback

“They have been a great asset to the team. Particularly useful is possible drug interactions between pharmaceuticals and natural

supplements/remedies. I hope we continue this service to patientts and support to clinicians.”

“My patients have been absolutely thrilled with the services. I am hearing words like ‘brilliant’ and ‘fantastic’. They are continually

finding ways to benefit our clinic and push the boundaries of pharmacy practice.”

QUESTIONS?

Email: Jason.Min@ubc.ca

Larry.Leung@ubc.ca