Roles of the clinical pharmacist

Tiffany Erickson, PharmD, BCPS

Pager: 559-9538, Voice mail/desk phone: 731-8120

E-mail: ttennant@u.washington.edu

In collaboration with the PCP, through individualized education, the clinical pharmacist assists with:

• Chronic condition co-management and education. Primarily includes diabetes, cardiovascular disease, anticoagulation, and asthma/COPD, but can include others.
• Travel medicine education and coordination of medications for international travelers
• Smoking cessation
• Mediset education and coordination
• Education of special devices such as insulin or other injections, glucometer, inhalers, peak flow meters, and more.
• Drug-information including formulary restrictions, drug pricing, patient refill history, and more.
• Consultations
• Setting up patients with multicultural diabetes education classes

Some guidelines for referral to pharmacist:

• Patient visits need to have documented referral and reason for visit to assure adequate billing/reimbursement. This can be done in chart note (easiest) or by a separate referral form.
• Scheduled appointments are the preferred method and can be requested on pink-sheet. Please request level 3 interpreter and include the visit reason.
• For requests to see patient in less than 2 weeks, please see the pharmacist to coordinate an overbook time.
• Tag-ons for patients seen that day are possible but:
• Due to space limitations, the pharmacist would need to do the teaching in your exam room if another room is unavailable
• For teaching of devices, strongly encourage interpreter to be present.

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International Medicine Clinic

Distribution pharmacy pearls

1. Prescription requirements

· Prescription must be legible and printed or typewritten (no cursive)

· Do not use dangerous abbreviations (see reference card for a list)

· Patient identification (patient ID is the only unique identifier)

· Updated allergy information

· Drug name, strength/dose, route, frequency of use, quantity, and indication for prn medications

· Refills authorized

· Prescriber’s name and UPIN

· Prescriptions are good for 1 year

2. PPR: Patient Profile Report
1. What it is:

· Contains current medication profile and date of last “activity”

· Is generated 1-2 business days before the visit

· Can be used at HMC as a legal prescription for new prescriptions or adding refills

· Cannot be used for certain controlled substances:

1) Oxycodone, methadone, codeine, hydromorphone, fentanyl

2) Hydrocodone and codeine combination products are ok

2. How to use it:

· Always verify you have the correct patient’s PPR

· Please add sufficient refills to last until next appointment

· When making changes to the profile, please stop the current med and write a new rx for the updated med and indicate reason for switch (this is helpful for insurance billing as well as history keeping)

· Do not hand patient the pages after the medication profile

· For outside meds, use a separate 2-ply rx, with pt sticker on both copies

· It is recommended you walk the patient to the pharmacy with the PPR

3. HMC/UWMC drug formulary

· On healthlinks, under “drugs,” click on UW Medicine Drug formulary

Pearl: Encourage your patients to bring all of their medication bottles to every visit.

· Preferred formulary includes cost-effective preferred drugs for commonly prescribed classes of drugs

4. Mediset program

· Provides prefilled medisets for stable patients

· Maximum of 2-week supply dispensed

· Pt must demonstrate compliance with pick-ups

5. Patient refill policy

· Patients are instructed to inform the pharmacy 2 business days before needing the refill, and patients can return later

· If no refills on prescription, the pharmacist will notify the provider for authorization

· Insurance and HMC charity care, mandate no more than 1 month supply given per month, i.e. no early refills

· It is the discretion of the dispensing pharmacist to make any exceptions to provide medications to avoid interruptions in care. In emergent situations, a 3-day supply will be given, which is allowable by the state at any pharmacy

6. Guidelines for patients traveling

· Patients are limited to 30 day supply by insurance and HMC charity care

· Any supply above this the patient will be asked to pay cash

Most travel medications are not covered by most insurance plans, including HMC charity care