Clinical Services:

Two clinical pharmacists, who specialize in Ambulatory Care, manage several specialty clinics including antithrombosis, lipid, pulmonary, hepatitis C and medication management. All of these specialty clinics are pharmacist-managed under approved protocols. Our pharmacists also provide drug information, medication recommendations, patient education and drug use evaluation to Internal Medicine and Family Practice residents, medical and pharmacy students, nurses and attending physicians during patients' clinic visits.

Specific Clinical Duties:

Antithrombosis clinic (better known as Coumadin® clinic) Patients receiving anticoagulant therapy are evaluated by the clinical pharmacists for therapeutic range, adverse drug reactions, diet and medication compliance and recurrence of thrombotic events. This clinic operates for 4 hours twice weekly. David Parish, MD is the attending for this clinic.

Lipid clinic Patients are admitted into this clinic if they have had a history of uncontrolled hyperlipidemia/hypertriglyceridemia despite appropriate medication therapy. Patients are monitored not only for improvement of lipid profile but also for adverse events. This clinic is held on Wednesday afternoons with John Hudson, MD as the clinic attending.

Pulmonary clinic This clinic allows our clinical pharmacists to concentrate on asthma, COPD and other pulmonary conditions in conjunction with our pulmonologists, Jonathan Dean, MD and Douglas Farman, MD. Patients are educated about their medications, adverse events and monitoring their own therapy. The pulmonary clinic received a grant from the Barham-Calhoun Foundation to allow better education and follow-up for this population in hopes of decreasing hospitalizations and improve quality of life.

Hepatitis C clinic Patients with hepatitis C are followed closely through lab monitoring, phone follow-up and personal visits with the clinical pharmacists. Patients are educated on the lab results, medications and outcomes of therapy. The clinic meets every Monday. Shahriar Sedghi, MD and Harold Harrison, MD are attending physicians.

Medication Management clinic Patients are referred to this clinic have a history of non-adherence with medications, need closer follow-up or have more than 6 prescribed medications. The clinical pharmacist works very closely with each patient on a weekly to monthly basis for improvement of their disease state management and quality of life by improving medication and appointment compliance. This clinic is operated on Tuesdays and Thursdays with the patient's primary care provider serving as a contact for the clinic pharmacist. Each medication is discussed with the patient (and/or family member if necessary) to help the patient understand why they are taking certain medications, how we monitor effectiveness/adverse events and how to use a pillbox to ensure compliance.

Congestive Heart Failure clinic In conjunction with the hospital's initiative, our clinical pharmacists participate in the education and medication management of the congestive heart failure population. An education form was developed to help the patients understand more about their disease state and proper ways to prevent complications and exacerbations. The congestive heart failure clinic is held the first Monday afternoon of each month during cardiology clinic.

In addition to clinic responsibilities, our clinical pharmacists also participate in community activities including a cardiac rehabilitation program, pulmonary rehabilitation program, special health related events (such as the Great American Smokeout) and Brown Bag Day events.

Kathleen Lindauer, Pharm.D. and Dina Salman, Pharm.D., BCPS serve as clinical pharmacists for these services.

Barbara Wyatt, Pharm.D. is the Clinical Pharmacy Manager for the Ambulatory Care Pharmacy.