50 Stories from 50 States
southeast

alabama

 

Samford University and Carroll Pharmacy

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Description of Pharmacy

Carroll Pharmacy has two locations in central Alabama, with the biometric screening services performed at the Trussville, Alabama location. These pharmacies have been family owned and operated since 1995. Trussville has a population of approximately 26,000 with a median household income of $97,000. Almost 57% of the city’s population is between the age of 18 and 65 years old.  

In addition to wellness screenings, between the two pharmacy locations, patients have access to all the traditional dispensing services as well as non-sterile compounding, point of care testing including strep, flu, and COVID-19 testing, immunizations, medication delivery, medication packaging, and more. 

About the Pharmacy

Carroll Pharmacy
Trussville, AL

http://carrollrx.com  

Meet the Team
 

Faculty Lead Contact: 

Terri Wensel 

 

Pharmacist Lead Contact: 

Raegan Fain 

 

Student Pharmacist: 

Lucy Rinehuls 

PHARMACY STORY

Within the past year, Carroll Pharmacy began offering onsite biometric screenings for government employees and public school employees, as determined by insurance guidelines for annual wellness visits. Some insurance programs are adding incentives or penalties to encourage their insured population to participate in an annual health screening. One insurance company, through the State Employee Insurance Board (SEIB), offers a reduction in health insurance premiums for those who participate. This not only incentivizes patients, but also helps identify high risk patients for future negative health outcomes. These negative outcomes can be mitigated with early intervention to improve patient’s health and decrease subsequent healthcare expenditures. During the biometric screening event, participants’ height, weight, body mass index, blood pressure, blood cholesterol, and blood glucose were assessed. Following screening, patients were provided written disease state education from the American Diabetes Association and/or American Heart Association – based upon their screening results, risk factors, and reported medical history. Studies have shown that biometric screenings can improve patient health outcomes and decrease health insurance costs for employer sponsored programs. Community pharmacists are in the perfect location to close the gap in healthcare as the most accessible healthcare provider. By utilizing the community pharmacy setting, patients can more easily access a healthcare provider to receive a biometric screening to not only receive a financial incentive, but also improve personal health outcomes when proper changes are implemented. Many patients who participated in these services expressed their gratitude for the convenient and welcome feeling of completing their wellness screening in their local independent community pharmacy in addition to the ease of the process since the pharmacist handled all associated paperwork for them.  Also, if referrals were necessary based on a patient’s individual results, the pharmacist would provide counseling and referral information in house so that each patient was well equipped with next steps prior to leaving his or her screening appointment.  

State/Federal Connections/Advocacy/Impact:

Through our state’s Blue Cross Blue Shield, the pharmacy is a registered provider of biometric screenings which allows the pharmacist to perform wellness screenings onsite to any insured patient or spouse who qualifies under their plan. As one of the most accessible healthcare professionals, community pharmacists are well equipped to close the gap in healthcare and increase key components of direct patient care. Pharmacists have the education and training necessary to provide services that continue to improve patients’ health, but pharmacists need to be recognized as providers to be able to ensure this level of care is provided to all members of a community.

arkansas

UAMS College of Pharmacy and
Don's Pharmacy 

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Description of Pharmacy

Don’s Pharmacy is located in Little Rock, AR, Congressional District 02, in which the Health Resources & Services Administration (HRSA) currently reports a total of 43 health professional shortage areas. Don’s Pharmacy is family owned and operated since its founding in 1959, and over the years they have grown to offer a plethora of products and services for their community, including: POC testing, medication synchronization, durable medical equipment, compounding, compliance packaging, and immunizations. Don’s Pharmacy clearly has a legacy of providing needed services to patients. Dr. Brooks Rogers, a pharmacist at Don’s, described an advantage of POC testing as, “a service that every pharmacy could offer,” and he hopes to continue, “expanding these types of POC tests we offer and keep pushing for provider status.” 

About the Pharmacy

Don's Pharmacy
Little Rock, AR

https://www.donsrx.com/ 

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Meet the Team
 

Faculty Lead Contact:  

Dr. Megan Smith 

Pharmacist Lead Contact:  

Dr. Brooks Rogers 

Student Pharmacist(s):  

Leah Evans 

PHARMACY STORY

Initial Presentation:

Not long after Don’s Pharmacy started offering point of care testing at their store, a young mother brought in her two daughters, one of which had been complaining of what she described as flu-like symptoms since waking that morning. After the mother explained the situation to the pharmacist on staff that day, they arranged a few Point-Of-Care (POC) flu tests for the whole family. The symptomatic daughter ended up testing positive for the flu; however, after a quick phone call to their pediatrician, the family walked out of the store in under thirty minutes with both treatment for the positive child and prophylaxis treatment for the rest of the family.  

Background:

Young mother with one daughter with the flu, and the other daughter with confirmed exposure.  

  • Had not yet been seen at pediatrician’s office for current symptoms due to cost and recent financial difficulties with patient family.  

  • Mother brought to Don’s Pharmacy after a coworker informed her of the POC tests being offered at the store to walk-in customers. 

Patient Report:

The patient reported:  

  • Muscle aches 

  • Fever 

  • Headache 

  • Sore Throat 

  • Runny nose  

 

Physical Observation:

Symptomatic daughter was ill-appearing on presentation to pharmacy with her family. Discussion with mother revealed that her daughter had been experiencing the symptoms described above. 

Intervention:

  • Point-of-Care Testing to guide appropriate treatment based upon test results. 

  • Collaboration with the family’s pediatrician to coordinate care and eliminate excessive trips to various medical offices in order to lower cost burden on the mother.   

    • Pharmacist described patient’s symptoms and flu POC test results to pediatrician. 

    • Pediatrician called-in treatment oseltamivir dose packs for positive daughter as well as two prophylactic oseltamivir dose packs for the exposed family members.

  • Counseling for the family to ensure the mother has an understanding of the differences in treatment and preventative dosing for the flu. The pharmacist also encouraged follow-up at the pharmacy and/or pediatrician.  

Outcomes of Care Provided:

Outcome 1: Medication Service / POC Testing  

The family was able to take care of an obviously stressful situation in under an hour because of the POC services offered and the initiative the pharmacist took to coordinate care with the family’s pediatrician.  

  • Once the mother realized she would not have to attempt to get into the pediatrician’s office that day because the pharmacist reached out to the pediatrician for their prescriptions, she was elated. The mother was clearly overwhelmed when she walked in the store, but she yelled to the pharmacist, “we’re never going anywhere else!” as she was walking out of the store with her little girls.  

 

Outcome 2: Cost Savings for Family / Patient Satisfaction  

When the pharmacist was speaking with the mother, it was obvious that cost was a barrier for her family to access medical treatment. Unfortunately, there are a lot of families that face the same barriers to healthcare in the area that Don’s Pharmacy serves, but the pharmacist on staff set a fantastic example of how much of an impact we can have on our patients by going the extra mile to help them through a stressful situation.  

 

Outcome to the Pharmacy:  

  • The pharmacist was able to increase access to care in a cost-effective and convenient manner for the family.  

  • Based on these efforts and the patient demand for pharmacist-provided care, new legislation was recently passed to expand pharmacists’ scope. In the future, this pharmacy will be able to provide treatment directly through a state-wide protocol. 

State/Federal Connections/Advocacy/Impact:

Pharmacists have been able to provide point of care testing for decades; however, the applicability of testing for infectious diseases such as influenza has led to new state legislation in Arkansas to make the process even more efficient for patients to receive timely treatment. Arkansas House Bill 1246 was approved in April of 2021, and it has allowed pharmacists to now prescribe medications to treat influenza, pharyngitis (caused by Group A streptococcus), or other CLIA-waved tests (alongside the state’s pharmacist and medical boards’ approval) in light of a positive POC test. With this new legislation, Don’s Pharmacy and many others in the state will make an enormous impact on the timely treatment of their patients in times of need.

 

UAMS College of Pharmacy and
East Gate Pharmacy 

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Description of Pharmacy

East Gate Pharmacy is a family-owned independent pharmacy serving Hot Springs Village in central Arkansas. This location services an older adult population whose median age is 75 years old living in a retirement community. This pharmacy is located in a designated Medically Underserved Area by the United States Health Resources and Services Administration. Additional services offered include 24-hour emergency services, collection of vital signs, home deliveries, tobacco cessation program, durable medical equipment, long-acting injectable administration, naloxone dispensing, nutritional counseling, and specialty medication compounding. 

About the Pharmacy

East Gate Pharmacy 
Lonsdale, AR
https://www.butlerpharmacies.com/east-gate-pharmacy

 

Meet the Team

Faculty Lead Contact 

Megan Smith, PharmD, BCACP  

 

Pharmacist Lead Contact: 

Cody Turner, PharmD 

 

Student Pharmacist(s): 

Jason Lam

PHARMACY STORY

Pharmacogenomics testing looks at specific genes to help determine and improve the selection of a particular drug treatment, which allows tailoring of dose and dosing schedule to the patient's genetic profile. Providing pharmacogenomics testing enhances drug effectiveness and reduces toxicity – an enormous value and importance for patients who may be experiencing comorbidities and polypharmacy.  

A 72 year old male [David] is an established customer of East Gate Pharmacy who’s been experiencing poor continuity of care between 2 to 3 providers. David expresses it as if he’s “receiving the short end of the stick” because he didn’t understand why he was switching between so many medications for his diabetes and was tired of the side effects he was experiencing. During a medication therapy review, the pharmacist discussed pharmacogenomic testing service and how it could provide additional information on why some medications might not be working as well as others. This would eliminate any further guesswork in the patient’s therapy. David gladly accepts and the pharmacist performs a cheek swab, prepares the sample, and sends it to a laboratory. After the results are available, the pharmacist reviewed the genetic report with David. The service was very well received and having the pharmacogenomics results is a “tangible piece of medication history that [the patient] can hand to his provider”.  David took the report to his next physician visit to discuss options for diabetes management.  David’s physician prescribed a shorter acting medication and confirmed the other medications were good options for him.  At the pharmacy, all actionable drug interactions were noted in David’s pharmacy profile and are used to guide counseling and assessment for all medications.  

florida

Palm Beach Atlantic University and 
Atlantis Pharmacy 

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Description of Pharmacy

Atlantis Pharmacy is an independent community pharmacy located one block north of JFK Medical center, a 486-bed acute care medical and surgical facility with comprehensive services including cardiovascular care, orthopedics, behavioral health and emergency services. The mission of the pharmacy is to work collaboratively with healthcare professionals to provide optimal pharmaceutical care to all patients. The pharmacy delivers comprehensive MTM services that include INR check, BP monitoring, diabetes care, and medication reviews. In addition, both JFK Medical Center and JFK Internal Medicine and Faculty Practice collaborate with the pharmacy to achieve positive patient outcomes. 

About the Pharmacy

Atlantis Pharmacy
Atlantis, Florida
https://www.atlantispharmacy.com/

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Meet the Team
 

Faculty Lead Contact:  

Erin Dorval, PharmD
 

Resident Pharmacist Lead Contact:  

Jessica Bailey, PharmD 

Pharmacist Lead Contacts:  

Jallena Roberts, PharmD 

Damien Simmons, PharmD, Pharmacy Manager 

PHARMACY STORY

Initial Presentation:

A gentleman [John Smith] called Atlantis Pharmacy inquiring about vaccine services for his home-bound mother [Miss Jane Smith] who lives with him in West Palm Beach (WBP), Florida. A two-person team, one resident pharmacist and one Advanced Pharmacy Practice Experience (APPE) student, was able to administer the COVID-19 vaccine to the 87-year-old female. 

Background:

Atlantis Pharmacy (AP) offers enhanced services such as INR monitoring, blood pressure checks, cholesterol and A1c monitoring, and vaccinations. During the COVID-19 pandemic, AP has extended vaccine services to include home visits to home bound patients within the Palm Beach County.   

Patient Report:

The patient’s son [John Smith] verbally stated being thankful for the Atlantis Team who vaccinated his mother. During the visit, the patient’s son made comments regarding the patient’s medications and the difficulty with administering. At the time, the patient’s son had to visit two different pharmacies to retrieve all medications. Plus, the patient has multiple administration times and the son had trouble keeping track if his mother took the medicine while he was at work. The pharmacy team offered our medication adherence packaging service to alleviate his issues. 

 

Physical Observation:

The Resident Pharmacist [Jessica] observed the limited physical ability of the 78-year-old patient. The patient [Miss Smith] qualified as a home-bound patient due to use of an assisted walking device (i.e. walker) and poor physical strength. The Resident Pharmacist also observed the patient’s son [Alex] has a current occupation of working from home. During the 15-minute post-vaccine observation period, the Resident Pharmacist utilized the time to talk with the patient and patient’s son about other Atlantis Pharmacy services, specifically medication adherence packages.   

Intervention:

During the vaccine encounter, the Atlantis Team collected the patient’s current pharmacy information, medication list, and insurance information. The Atlantis Team discussed the benefits to medication adherence packaging for the patient to help reduce the son’s stress of caregiver roles. The Resident Pharmacist made a plan with the patient’s son to inquire about transferring medications and starting an adherence-pack.  

 

Outcomes of Care Provided:

Outcome 1: 

The patient struggles to receive vaccines due to limited physical ability in transportation to pharmacies. The patient lives with her son, who is able to assist her with moving around their home. Despite this, the son does report struggling in transporting his mother outside of the home for vaccines. The two-dose COVID-19 vaccine series was administered to the home-bound patient by bringing the resources to the patient’s home.  

 

Outcome 2:

​The patient’s caregiver reports difficulty in assisting the patient to take medications daily. The patient [Miss Smith] has an aid who comes weekly to the house. Therefore, on a daily basis the patient [Miss Smith] struggles to remember taking all her medications as prescribed. The son also reports concern in ensuring his mother took her medications since the pills are kept in original prescription bottles from the pharmacy. At the time, the patient does not use a pillbox. The patient was added successfully to the Medication-on-Time (MOT) adherence packaging service within Atlantis Pharmacy. The Resident Pharmacist collected the patient’s full medication list, including prescriptions and non-prescription medication. The Resident Pharmacist worked with the patient’s caregiver to create a monthly patient-targeted adherence package. 

State/Federal Connections/Advocacy/Impact:

South Florida is a geographic location known too many for its retirement communities. Therefore, many businesses within the area service both retired ‘snow birds’ and year-round retirees. Members of the community who identify as retirees and/or are consider a part of the elderly population have many different living situations which means these individuals may or may not have assistance in daily living activities, including managing their medications. We, as a pharmacy, offer medication adherence packaging to our patients including retirees and non-retirees. The adherence packaging in general provides several benefits to our patients including: assistance in ensuring all medications are taken at the correct times and reducing drug interactions. Secondly, adherence packaging can be a useful option in patients who experience: difficulty in handling medication pills due to arthritis, poor eyesight, and forgetfulness (i.e. Alzheimer’s disease). Lastly, adherence packaging can also provide support to patient’s families who may play the role of caregiver. 

 

georgia

Barnes Drug Store 

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About the Pharmacy

Barnes Drug Store
Valdosta, Georgia
https://refills.barneshc.com/

 

 

kentucky

University of Kentucky and 
Silvers Hometown Pharmacy 

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About the Pharmacy

Silvers Hometown Pharmacy
Monticello, KY
https://silvershometownpharmacy.com/

PHARMACY STORY

The University of Kentucky College of Pharmacy has partnered with the College of Agriculture, along with Kentucky State University, a public historically black land-grant university in our state’s capitol of Frankfort, KY to increase vaccine access and education, specifically in underserved patient populations.  This partnership was developed to strengthen immunization education with a special focus on adult vaccination hesitancy around both COVID and other adult immunizations. Our collaboration in Kentucky is specifically aimed toward increasing vaccinations in nine counties with the lowest vaccination rates; Bracken, Daviess, Fayette, Franklin, Hardin, Jefferson, Louis, Pendleton, and Wayne.  To serve these communities, we have developed a plan to coordinate vaccine clinics and other health promotion events through local independent pharmacies and local ag extension offices.  The funding for this project has allowed us to hire a student pharmacist to coordinate this process, as well as work with faculty members and local community pharmacists to educate and vaccinate underserved communities. 

Wayne County, KY remains below the national percentage of COVID19 vaccinations, demonstrating a great need for COVID vaccination education in the area. People who are vaccinated with at least one dose make up 47.9% in Wayne County compared to 78% nationally and 41% of the population are fully vaccinated compared to 66% nationally. This summer, we were presented with an opportunity to work with Wayne County’s extension office to create a vaccination clinic at the Wayne County Expo in Monticello, Kentucky. The Expo hosts a wide variety of events from beauty pageants to horse shows and therefore gives us a large target demographic. Dr. Bryan Childers of Silvers Pharmacy was the ideal partner for this collaboration.  He has worked tirelessly to continue to provide care to the members of his community, including many outreach opportunities to ensure that patients receive the vaccinations that they need.  We were able to work together to identify three vaccines to provide at this event: Tetanus, Pneumococcal and Herpes Zoster (Shingles) Vaccinations. We also decided that we would focus on educating the public on the importance of COVID vaccinations. We developed COVID19 educational materials to distribute as well as a plan to help patients set up appointments for COVID19 vaccines at nearby facilities. 

While Kentucky pharmacists have played a significant role in vaccinating their communities for nearly 20 years by authority of our Pharmacy Practice Act, Kentucky Revised Statute 315.010, recent state regulation making Kentucky compliant with the HHS PREP Act, expanded pharmacists’ ability to provide vaccinations.  It allowed pharmacists to order and administer vaccinations to children between ages 3 and 17, pursuant to the ACIP vaccination schedule; it also allowed pharmacists interns and pharmacy technicians to administer vaccinations to children between ages 3 and 17.  These expansions have proved to be instrumental in continued access to care that is so needed, especially in our underserved patient populations. 

YouTube video short linked here

 

Glenn's Pharmacies 

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About the Pharmacy

Glenn's Pharmacies
Marion and Salem, KY
https://www.glennspharmacies.com/

louisiana

University of Louisiana at Monroe and 
St. Vincent De Paul  

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Description of Pharmacy

St. Vincent de Paul Community Pharmacy in Monroe, Louisiana, is one of the 12 registered charitable pharmacies in the state of Louisiana. Four of these charitable pharmacies fall under the umbrella of the Society of St. Vincent de Paul. The median income of the area is approximately $41,000 and nearly 25% of the population falls below the poverty line. According to the United States Health Resources and Services Administration, Monroe, Louisiana and other parts of Ouachita Parish are designated Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA). Non-profit, charitable organizations such as St. Vincent de Paul (SVDP) provide medication for free to low-income or uninsured patients. SVDP relies on help from volunteer pharmacists and other individuals to fill prescriptions and deliver a variety of health services. Services offered at this site include dispensing non-controlled medications, medication therapy management, chronic disease care and education, and free diabetic testing supplies. Donations and funding from grants and local sponsors are vital for SVDP to provide care in the community. 

About the Pharmacy

St. Vincent de Paul Community Pharmacy
Monroe, LA
https://www.facebook.com/stvincentdepaulcommunitypharmacy/

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Meet the Team
 

Faculty Lead Contact:  

Ashley Barbo 

 

Pharmacist Lead Contact:  

John Biglane 

 

Student Pharmacist(s):  

Tiona Harris 

Blair Guillory 

PHARMACY STORY

Initial Presentation:

Student pharmacists from the University of Louisiana Monroe (ULM) held a Diabetes Education and Supply Drive at St. Vincent de Paul Community Pharmacy (SVDP) to kick off National Diabetes Month in November. This event was hosted by the ULM Student National Pharmaceutical Association’s Fighting Diabetes initiative. As patients arrived at the pharmacy, the pharmacist and students provided information about Type 1 and Type 2 diabetes, risk factors for developing diabetes, medications used to manage diabetes, and advice on diet and exercise. Patients were also given free diabetic testing supplies including monitors, lancets, and test strips. 

Background:

St. Vincent de Paul Community Pharmacy (SVDP) serves mostly low-income and underinsured/uninsured patients in a medically underserved area of Louisiana. About 35% of the patients at SVDP have diabetes and utilize the pharmacy to obtain free medication and testing supplies to manage their diabetes. Several patients who visited the pharmacy during the event shared personal stories about the challenges they often face to afford their basic health care needs. 

 

Patient Report:

A patient arrived at the pharmacy to pick up insulin for her husband. She shared that her husband was diagnosed with Type 2 Diabetes, and he would be starting insulin injections in addition to the Metformin he was previously prescribed. The patient showed a strong desire to understand more about diabetes so that she could better support her husband and encourage him to adhere to his new medication regimen.  

Intervention:

Education: The pharmacist along with the student pharmacists took the following steps to educate the patient on diabetes: 

  • Explained the difference between Type 1 and Type 2 diabetes, 

  • Described how Metformin and insulin work in the body to treat diabetes, 

  • Provided a free blood glucose monitor, lancets, and test strips and demonstrated how to use these supplies to check blood glucose levels,  

  • Offered diabetes-friendly recipes and healthy eating handouts as supplement information. 

Planned future events to provide health education, diabetic screenings, and collect donations/redistribute free testing supplies to other members of the community.

 

Outcomes of Care Provided:

Outcome 1: Compliance 

In the following weeks, the patient reported to the pharmacist that her husband was managing his diabetes with Metformin and insulin injections as well as diet and exercise. 

 

Outcome 2: Cost Savings 

The patient used the monitor, lancets, and test strips she was given to help her husband check his blood glucose each day. By obtaining these supplies for free, the patient can use financial resources to purchase food, clothing, and other necessities. 

Outcome 3: Patient Satisfaction 

One patient wrote a letter to the pharmacist expressing gratitude for other services he has received from the pharmacy. He said, “St. Vincent de Paul Pharmacy has been a blessing for me. A couple of years ago, my health took a turn for the worse. I spent over seven months in the hospital. After being discharged, I found myself in a difficult situation. I needed a large number of medications that I could not afford. Thanks to St. Vincent de Paul Pharmacy, I have been able to receive the medication needed to manage my health. God bless the staff at St. Vincent de Paul.”  

Outcome to the Pharmacy: St. Vincent de Paul saves the community between $1-1.5 million annually. The pharmacist at SVDP has the opportunity to form a personal relationship with each patient and effectively counsel on new medications or dose changes. Counseling sessions may last anywhere from 30 minutes to an hour to answer patients’ questions and provide important information. Diabetic patients are given the supplies they need to manage their diabetes at home.

State/Federal Connections/Advocacy/Impact:

Since 1989, Louisiana legislation has authorized charitable pharmacies such as St. Vincent de Paul Community Pharmacy to dispense prescription drugs to qualified patients free of charge. These non-profit organizations may accept unexpired prescription drugs that have not been tampered with as donations in accordance with legislature effective in 2004. By collecting unused prescription drugs and redistributing them to qualifying individuals, SVDP aims to increase medication access to an underserved population. The pharmacist at SVDP takes caring for patients a step further through collaboration with the National Association of Free and Charitable Clinics. The pharmacist noticed approximately 35% of his patients have diabetes, so he purchases diabetic testing supplies at a reduced price and then distributes these supplies at no cost. St. Vincent de Paul is an important point of care for many individuals in the Monroe community. Social determinants such as lack of transportation, unstable housing, or food insecurity make it difficult for someone to prioritize their health, so volunteers at SVDP work with patients to increase their access to health care services and improve their conditions. In order to make providing this level of care feasible, lack of financial resources and a lack of public awareness of or participation in the drug recycling program should be addressed.  

 

mississippi

University of Mississippi School of Pharmacy and G&M Pharmacy 

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Description of Pharmacy

G&M is a part of a group of independent pharmacies in North Mississippi. G&M services mainly Oxford, Mississippi. The Centers for Medicaid and Medicare Services considers Oxford a rural area. Oxford has a shortage of primary healthcare, dental care, and mental healthcare. Oxford is also designated as a medically underserved area. G&M Pharmacy and the Tyson Family of stores provides its customers with a robust adherence and medication synchronization program, extensive vaccinations, adherence packaging, delivery services, and much more. The owner and lead clinical pharmacist make sure the pharmacy is active within CPESN and lead the state in innovative practices. 

 

About the Pharmacy
 

G & M Pharmacy, a Tyson Drugs Pharmacy 

Oxford, Mississippi
https://gandmpharmacy.com/ 

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Meet the Team

Faculty Lead Contact: 

Jordan Ballou 

 

Pharmacist Lead Contact: 

Ashley Miller 

Student Pharmacist: 

Michaela Nowell 

PHARMACY STORY

Background:

Our story isn’t just one patient. At G&M Pharmacy, we had the privilege of ordering and vaccinating most of the patient population at a long term and memory care facility. We were able to provide COVID booster and flu vaccines that we ordered and provided on site. We vaccinated over 50 residents along with several staff members. Providing these vaccines especially in these populations is vital to public health. Communicable diseases can spread quickly and easily through these communities and outside of them. Family members are coming in and out and taking germs home to other family members who can then spread it throughout the wider community.  

 

Patient Report:

Our patients included residents at a long term and memory care facility in Oxford, MS. The population was relatively elderly, but spanned the spectrum of disabilities, mental status, and overall health. 

Intervention:

We ordered and administered 50+ vaccinations to the residents that were eligible and had been given consent by either themselves or their guardians. We were also able to vaccinate staff while on site. 

 

Outcomes of Care Provided: 

Outcome to the Pharmacy: 

Our pharmacy has been able to increase our presence in the community and help vaccinate a large portion of our population. We have developed new relationships with local businesses and our local health departments. We have brought in new patients to our pharmacies and are able to foster those relationships in order to better serve our community and continue providing top tier health care in our communities. 

State/Federal Connections/Advocacy/Impact:

The federal executive order allowing all pharmacists to order and administer vaccinations made this possible. And while the executive order is fantastic, it is only a temporary solution. Mississippi pharmacists are working tirelessly to find more permanent solutions in our state. This effort is being led largely by CPESN pharmacists and state organizations. 

University of Mississippi School of Pharmacy and Right Way Meds  

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Description of Pharmacy

Right Way Meds is located in the rural town of Holly Springs, Mississippi. Holly Springs has a population of 7,737 people and has a size of 12.8 square miles. The median age is 35.2 years old. The population is 81% African American and 17% Caucasian with the remaining being Hispanic and those with two or more ethnicities. Approximately 32% of the population lives below the poverty line. The per capita income is $13,530 and the median household income is $27,190.  

 

Right Way Meds is one of four locations belonging to Tyson Drug Inc. Each of these locations are independently owned pharmacies that offer many services including medication reconciliation, clinical medication synchronization, immunizations, comprehensive medication reviews, and adherence packaging.  

 

Right Way Meds specializes in adherence packaging in order to make the process of taking medications easier on patients. The adherence packaging is sorted by date and time and placed into convenient pull out boxes. Pre-sortment, free delivery, and monthly check-ins are just a few of the ways that Right Way Meds is able to help patients maintain their health and stay on top of taking care of their health.   

About the Pharmacy
 

Right Way Meds, a Tyson Drugs Pharmacy 

Holly Springs, Mississippi
https://rightwaymeds.com/

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Meet the Team

Faculty Lead Contact: 

Jordan Ballou 

 

Pharmacist Lead Contact: 

Bob Lomenick 

 

Student Pharmacist: 

Jacey Gossett 

PHARMACY STORY

Initial Presentation:

A 49 year-old male patient had been a customer at the pharmacy that was receiving adherence packaged medications. The patient had previously been consistently non-adherent and having his medications packaged into morning and evening doses with time stamps was very beneficial for him remembering to take his medications. Although the adherence packing was very helpful for him, he was trying to transfer his prescriptions out of the pharmacy because his medications were less expensive at other pharmacies. Although he had Medicaid insurance, it only paid for a limited number of medications and the patient had to pay for the additional medications.

Background:

The patient was taking medications for heart failure, diabetes, mental health, and chronic lung disease. He was prescribed a total of 13 medications, but his insurance only covered up to 5 of these. Therefore, the patient had a significant financial burden from his prescription medications.

 

Patient Report:

As a result, the patient reported that for convenience and to save money, it would be better for him to change to a pharmacy that offered lower cash prices for some of his medications.

Intervention:

To help the patient decrease their out-of-pocket prescription expenses and continue receiving adherence packaging for his medications, the pharmacy called Medicaid and was able to get authorization for coverage for all of his medications. Additionally, the pharmacy provided delivery of his medications in their convenient packaging.

 

Outcomes of Care Provided:

The pharmacy was able to get the patient’s medications fully covered by his insurance, resulting in a significant decrease in financial burden and potential non-adherence. Since the patient was able to continue receiving adherence packaging for his medications, he will be able to take his medications as prescribed, resulting in better control of his medical conditions. Overall, the patient was highly satisfied with his experience at our pharmacy.  

State/Federal Connections/Advocacy/Impact:

Being a participant in CPESN allowed our pharmacy to effectively take care of our patient due to providing enhanced services supported by CPESN such as adherence packaging with patient coaching and home delivery. Enhanced services help to address the medication needs of complex patients to improve health outcomes and decrease total healthcare costs. Being a participant in CPESN allowed our pharmacy to effectively take care of our patient due to providing enhanced services supported by CPESN such as adherence packaging with patient coaching and home delivery. Enhanced services help to address the medication needs of complex patients to improve health outcomes and decrease total healthcare costs. 

 

north carolina

Avant Pharmacy and Wellness Center

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About the Pharmacy
 

Avant Pharmacy and Wellness Center 

Charlotte, NC 
https://avantpharmacy.com/

 

oklahoma

Southwestern Oklahoma State University and Osborn Drugs Pt. 1

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Description of Pharmacy

Osborn Drugs is an independent community pharmacy located in Miami, Oklahoma. Miami is a small rural town with a population of around 13,000 people. In 2019 the median household income for Miami was around $36,908. Osborn Drugs provides several services including durable medical equipment, medication therapy management, long term care, compounding, immunizations, PakMyMeds, medication synchronization, free delivery, gifts, and more. Osborn Drugs has been serving the community for 50 years with their motto, “The only thing old-fashioned about us is our service!” Osborn Drugs is a part of the ProRX network that encompasses over 25 locations in Oklahoma, Kansas, Missouri, and Arkansas. Osborn Drugs is also part of CPESN Oklahoma and recently participated in and completed Flip the Pharmacy’s practice transformation.  

About the Pharmacy

Osborn Drugs
Miami, OK

https://www.osborndrugs.com/

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Meet the Team
 

Faculty Lead Contact:  

Leanne Showman, Pharm.D.   

 

Pharmacist Lead Contact:  

Bill Osborn, R.Ph. 

 

Student Pharmacist(s):  

Brianne Crews 

PHARMACY STORY

Initial Presentation:

A 68-year-old female patient [Suzy] visited Osborn Drugs to pick up a new medication for her new-onset atrial fibrillation. The patient’s doctor had prescribed an expensive medication. Uninsured, the patient was left distraught.  

Background:

Suzy’s doctor had prescribed:  

  1. Xarelto for new onset atrial fibrillation 

Patient Report:

The patient reported:  

  • Distress due to health and financial concerns. 

  • Her doctor’s firm position against substitutions regarding the prescribed medication. 

Observation:

I remembered a previous community rotation where a patient mentioned a discount they received through the medication’s manufacturer. I notified my pharmacist, who encouraged me to further investigate. The pharmacist then reassured the patient he would find a way for her to receive the medication without breaking the bank. 

Intervention:

  1. Research: I was able to find a patient assistance program through Janssen that would allow the patient to get a 90-day supply of Xarelto for $10 instead of the regular $240. I was careful to ensure the coupon’s terms and conditions carried no adverse effects for the patient down the road. I explained my findings to the pharmacist who was assisting the patient. 

  2. Benefits: My pharmacist encouraged me to speak with the patient so that I could gain experience with solving patient dilemmas I helped the patient sign up for the benefit.  The patient was given the option to continue with this plan to ensure that her Xarelto prescription would continue to be discounted with some limitations.

Outcomes of Care Provided:

Outcome for Patient: Compliance  

The patient emotionally expressed her gratitude to the pharmacist and me. 

  • The patient noted that, before we found this discount, she planned to move forward without the medication.  

  • With the discount, Suzy was able to purchase, and continue to purchase, her medication. 

 

Outcomes for Osborn Drugs: 

  • Suzy was already an Osborn Drugs patient, but now would share her story with her friends at her church. 

  • Before leaving that day, Suzy told the pharmacist-in-charge, “this is why I come to you guys, because I know I will be taken care of.”  

  • This heartwarming experience demonstrated to other employees the importance of going above and beyond to take care of our patients.   

State/Federal Connections/Advocacy/Impact:

The care provided to Suzy was made possible through the CPESN PPOk-RxSelect Network and the Flip-the-Pharmacy practice transformation. Flip-the Pharmacy aims to move pharmacies from filling prescriptions individually towards a more longitudinal care model. With Osborn Drugs going through the six domains ACT provides, we were able to use Domain Three specifically (Developing New Roles for Non-Pharmacist Support Staff) to help address challenges like social determinants of health. Without insurance, Suzy could have been forced to pay full price, or leave the pharmacy without her medication. With this practice transformation, however, we were able to use pharmacy interns to ensure that Suzy received the drug therapy that she needed.   

 

Southwestern Oklahoma State University and Osborn Drugs Pt. 2

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Description of Pharmacy

Osborn Drugs is an independent community pharmacy located in Miami, Oklahoma. Miami is a small rural town with a population of around 13,000 people. In 2019 the median household income for Miami was around $36,908. Osborn Drugs provides several services including durable medical equipment, medication therapy management, long term care, compounding, immunizations, PakMyMeds, medication synchronization, free delivery, gifts, and more. Osborn Drugs has been serving the community for 50 years with their motto, “The only thing old-fashioned about us is our service!” Osborn Drugs is a part of the ProRX network that encompasses over 25 locations in Oklahoma, Kansas, Missouri, and Arkansas. Osborn Drugs is also part of CPESN Oklahoma and recently participated in and completed Flip the Pharmacy’s practice transformation.  

About the Pharmacy

Osborn Drugs
Miami, OK

https://www.osborndrugs.com/

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Meet the Team
 

Faculty Lead Contact:  

Leanne Showman, Pharm.D.   

 

Pharmacist Lead Contact:  

Bill Osborn, R.Ph. 

 

Student Pharmacist(s):  

Brianne Crews 

PHARMACY STORY

Initial Presentation:

A 45-year-old female patient [Sarah] is a regular patient at Osborn Drugs. She comes in around once per week due to having a family of 7 who are all on different medications.  .  

Background:

Sarah has five children. Each child is taking an allergy medication of a different strength, and some are also prescribed medication for their ADHD. Sarah and her husband each take around 6 medications, as well. Every month their family fills around 25 medications, not including medications for seasonal illnesses like the flu, strep, etc. 

Patient Report:

The patient reported:  

  • Distress relating to the high frequency of her visits, often forgetting to refill medications.  

  • Needing a better way to keep track of her family’s medications. 

  • One of her children not taking their allergy medications for approximately one month and being sick most of the month.  

Observation:

Sarah and her family are the perfect patients for medication synchronization. If all of Sarah’s medications were synched with the rest of her family’s medications, she could reduce her pharmacy visits, as well as improve her children’s medication adherence.  

Intervention:

  1. Counseling: The pharmacist spoke with Sarah about her medications and solved her children’s medication adherence issues.  The pharmacist explained medication synchronization and how they could synchronize all the medication refills.  The pharmacist counseled Sarah on the importance of medication adherence and how medication synchronization can help. 

  2. Medication Synchronization: The technician in charge of medication synchronization spoke with Sarah to enroll her.  In the following months, the technician worked hard to get Sarah’s family’s medications synched. The pharmacists at Osborn Drugs continued to counsel Sarah on the importance of medication adherence.

Outcomes of Care Provided:

Outcome for Patient: Adherence  

Sarah expressed her gratitude to Osborn Drugs for helping her family get back on track with their medications. 

  • The patient no longer had to make 10-12 trips/month to the pharmacy.  

  • Sarah’s husband and five kids were able to get their medications on time without worrying about forgetting a prescription.  

 

Outcomes for Osborn Drugs: 

  • Sarah was already an Osborn Drugs patient but would now spread the word to her family and friends about medication synchronization.  

  • Osborn Drugs staff no longer spends excessive time finding medication refills for Sarah’s family. 

  • Osborn Drugs now tracks Sarah’s medication synchronization through eCare Plans.  

State/Federal Connections/Advocacy/Impact:

The care provided to Sarah was made possible through the CPESN PPOk-RxSelect Network and the Flip-the-Pharmacy practice transformation. Flip-the Pharmacy aims to move pharmacies from filling prescriptions individually towards a more longitudinal care model. Osborn Drugs was able to use Domain One specifically (Leveraging the Appointment-Based Model) to help further medication synchronization and improve medication adherence. Using the tools provided by Flip-the-Pharmacy, Osborn Drugs has improved their medication synchronization, and was able to assist Sarah’s entire family in becoming more adherent. Moving toward the appointment-based model, Sarah now only visits once per month to pick up her scheduled medications and receive counseling from our pharmacists.  

puerto rico

University of Puerto Rico and Farmacia Sagrado Corazon

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About the Pharmacy

Farmacia Sagrado Corazon
Sabana Grande, PR

https://www.farmaciasagradocorazon.net/

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Description of Pharmacy

As an owner of two community pharmacies for fourteen years and a pharmacist working within the profession for twenty-three years, the practice of community pharmacy has provided me with the opportunity to contribute to the advancement of healthcare within my town. The community pharmacy practice scenario, where I have been working as a pharmacist for twenty-three years and as the owner of two local pharmacies for fourteen years, has given me the opportunity to contribute to the health system of my town. Farmacias Sagrado Corazón, Inc. are located in Sabana Grande, a small town in the southwestern area of ​​Puerto Rico. This geographical area of Puerto Rico was heavily affected by natural disasters in recent years, such as hurricanes and earthquakes.  The pharmacy serves communities of the southwest area of the island, including infants and the elderly. I am proud of my pharmacies because they provide an accessible place of healthcare services for my patients, allowing them to achieve health and wellness outcomes. One of the aspects that make me prouder is that my pharmacies provide an accessible place of healthcare services for my patients to allow them achieving health and wellness. 

One of our locations is a typical traditional pharmacy, and the other is a holistic pharmacy that integrates traditional prescription drugs with complementary medicine. The pharmacy offers alternatives to patients who seek to improve their lifestyles with healthy eating and supplementation, integrating a balanced traditional and alternative medicine. 

Services include clinical programs in collaboration with Medicare advantage health insurances to provide screening for the early detection of undiagnosed chronic health conditions. Also, the pharmacy promotes medication adherence and provides medication home delivery to contribute to promote reaching the national goals established by the Center for Medicare and Medicaid Services (CMS). We also reconciliated patient medications post-discharge to facilitate accurate and safe transitions of care. As pharmacists, immunization is another service we provide in the pharmacy and to patients at home to prevent infectious diseases. The pharmacy also collaborates with other organizations and healthcare providers to coordinate health clinics to provide a variety of healthcare services to the community. 

The pharmacy automated the dispensing services to optimize the time it takes and prevent medication errors. Special populations, such as persons with visual impairments and the elderly, benefit from our specialized dispensing services, such as electronic audible labels and unit  –doses packaging. The pharmacy is also certified by the Joint Commission to dispense durable medical equipment to patients with diabetes, such as specialized shoes and glucose monitoring devices. A non-sterile compounding laboratory is also available to prepare personalized non-sterile formulations to address unique dermatologic conditions, women's health, gastroenterological disorders, among many other products. 

At the pharmacy, frequently, our community frequently benefits from health screening clinics to early screen for undiagnosed diabetes, hypertension, and other chronic conditions. Also, the pharmacy collaborates in different civic and sports activities to take the message of health diseases prevention and healthy lifestyles. The pharmacist also collaborates with veterinarians in the southwestern area to dispense the required medications and formulations to treat animal diseases. 

PHARMACY STORY

Through the years, we have heard many heartbreaking and compassionate stories from our patients and their families. Recently, a case close to our heart was a 40 -years-old male patient with a rare condition on his foot called erythromelalgia. This condition causes severe chronic pain on the extremity, limiting the patient's walking and daily living activities, which decreases his quality of life. Because of his condition, he lost his job as a US Postal Service mail carrier due to his inability to fulfill his work responsibilities. This health situation had the devastating consequence of becoming unemployed as a US Postal Service mail carrier because he was unable to fulfill his responsibilities. The patient’s physiatrist physician consulted the pharmacist to identify a personalized, topical, non-traditional compounded formulation in attempt to relieve his uncontrolled pain that keeps him bedridden most of the day. The pharmacist recommended a topical analgesic formulation compounded with amitriptyline and ketamine. This prescription not only improved the patient’s incapacitating pain, but also and significantly improved his overall quality of life. The patient is fully satisfied with the response to this non-traditional alternative of therapy and was extremely grateful for the innovation of this compounded medication that helped take his pain away. 

This is a particular story that demonstrates how pharmacists can have a positive impact in the life of our patients and how the innovative services provided at the community pharmacy contribute favorably to the health of our population. In this story, the interprofessional collaboration between the physician and the pharmacist to identify alternatives demonstrated that improvements in the patient’s health. is demonstrated. Also, the pharmacy team, including pharmacy technicians, and the student pharmacists, integrate in the pharmacist patient care process to interview the patient, collect the relevant data, assess the patient and finally, and prepare the formulation that will be dispensed to the patient. 

The pharmacist service at the community pharmacy through the recommendation and preparation of a personalized topical non-traditional formulation has a significant impact in a patient with a condition with limited treatment options. The positive outcomes of the pharmacist intervention, in collaboration with the physician, are, among others include but are not limited :to a reduction in additional medical expenses, prevention of the utilization of drugs with potential misuse and abuse, as the opioids, reduction in physical therapy that contributes to medical expenses, reduction in systemic medication potential adverse effects, and prevention of an early disability of a young productive patient due to chronic incapacitating pain. 

State/Federal Connections/Advocacy/Impact:

Since 2017, the pharmacy team founded the Farmacia Comunitaria Foundation, a non-profit organization that provides services to those who were most affected by Hurricane Maria. The main purpose is to provide access to medications to people who live in those remote communities severely impacted by the disasters. The foundation provides access to medications for the most isolated populations following  disasters, such as Hurricane Maria, the earthquakes in January 2020, and the COVID-19 pandemic in March of 2020. 

In 2002, the pharmacy began to integrate student pharmacists into all the services and community activities that the pharmacy provides as their introductory pharmacy practice experiences beginning during their first professional year. Those experiences contribute to the development of the expected curricular competencies. My professional contribution as a pharmacist goes beyond being a community pharmacy owner. I actively participate in local and national professional organizations, such as the Colegio de Farmacéuticos de Puerto Rico (Puerto Rico Pharmacists Association) as Community Pharmacy Committee member, Asociación de Farmacias de Comunidad de Puerto Rico (Puerto Rico Community Pharmacy Association), Cooperativa de Farmacias Puertorriqueñas – COOPHARMA (Puerto Rican Cooperative Pharmacies) and the National Community Pharmacy Association (NCPA). 

In this way, we contribute to the well-being of our profession by serving as an example and expanding beyond the scope of traditional pharmacists’practices. At the state level, the pharmacist is not officially viewed as a healthcare provider. In relation to the integration of the pharmacist in areas other than prescription dispensing and vaccination, there is no public policy on the government side that stands out our role as pharmacists. Unfortunately, the implementation of federal public policy at the state level in relation to, for example, point of -care services, is not viewed favorably and currently presents many obstacles to achieve. However, many pharmacist-led forums are working arduously in order for pharmacists to gain provider status within the United States.  The impact that the pharmacist as a healthcare provider can bring to communities is invaluable. Pharmacists must be recognized as providers in the health system to expand those services that many patients would benefit from to enhance their health outcomes and overall quality of life. Even more, to expand all the collaborative services that the pharmacist can do. 

 

south carolina

Medical University of South Carolina  and MUSC Health Ambulatory
Pharmacy Services

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About the Pharmacy

MUSC Health Ambulatory Pharmacy Services
Charleston, SC

https://web.musc.edu/

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Description of Pharmacy

The PCT team is an important part of Ambulatory Pharmacy Services at MUSC Health Charleston. Ambulatory Pharmacy Services encompasses programs in clinic-based pharmacotherapy, specialty pharmacy, infusion pharmacy, and outpatient pharmacy. MUSC Health Charleston provides care at sites on the medical center’s main campus in downtown Charleston, as well as in surrounding areas including West Ashley, James Island, North Charleston, and Mount Pleasant. The PCT team are clinical pharmacy specialists who provide medication review and interventions for patients who have multiple medications or health conditions. The PCT team practices under CDTMs (diabetes, hypertension, tobacco use, anticoagulation, and cholesterol) in partnership with physician champions. Their work also includes other health care professionals (physicians, nurses, physician assistants) and learners (PGY-1 Community-Based Pharmacy residents, PGY-2 Ambulatory Care Pharmacy residents, PGY-1 Pharmacy Practice residents, medical residents, and College of Pharmacy students.) The Ambulatory Pharmacy Services also offer multiple outpatient pharmacy locations on the medical center campus, in the surrounding community (North Charleston), and offer mail- order services for prescription needs. Patients can receive many types of care including one-on-one appointments with the clinical pharmacy specialist (delivered face-to-face or through telehealth), medication reconciliation, point- of- care testing, lifestyle education, and disease management. The services provided by the PTC Team are complemented by outpatient pharmacy services, including medication therapy management (comprehensive medication reviews, personal medication records), immunizations, and medication synchronization. All provide a fruitful environment for training of students and residents in clinical decision making, disease state management and education, and additional clinical services. Ambulatory Pharmacy Services has a strong partnership with the MUSC College of Pharmacy. Multiple College of Pharmacy faculty practice within Ambulatory Pharmacy Services and the PGY-1 Community-Based Pharmacy Residency program is directed by a College of Pharmacy faculty member. 

 

Care at MUSC Health Charleston is provided throughout the tri-county area, including Charleston County, Berkeley County, and Dorchester County.  MUSC Health Charleston is primarily located in Charleston, South Carolina (Charleston County).Charleston County has a population of 143,000 residents with a median age of 34. Sixty five percent of the population are between the ages of 18 and 64. The population is 53% female, 72% white, 22% black, 2% Asian and 3% Hispanic. The median household income is $79,359, however 12.2% of the population live at or below the poverty line. Portions of Charleston County are considered medically underserved areas, including dental health, mental health, and primary care.  The rate of primary care physicians per person is 12.3: 10,000. Charleston County has a diagnosed diabetes prevalence of 11.2%.1,2,3 These statistics support the expansion of pharmacists in disease statement management roles within our local area and the state of South Carolina. 

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Meet the Team
 

Faculty Lead Contact:  

Kristy Brittain, PharmD, BCPS, CDCES – Associate Professor, MUSC College of Pharmacy & Clinical Pharmacy Specialist, MUSC Health 

 

Pharmacist Lead Contact:  

Aulbrey Drisaldi, PharmD, BCPS – Clinical Coordinator, MUSC Health 

 

Residents: 

Katherine Henn, PharmD – PGY2 Ambulatory Care Pharmacy Resident 

Hayley Davis, PharmD - PGY2 Ambulatory Care Pharmacy Resident 

PHARMACY STORY

Hey Siri, what’s my glucose? It was not your average day at the MUSC Health Pharmacotherapy clinic when clinical pharmacy specialist, Dr. Cara Fossum and PGY-2 Ambulatory Care resident, Dr. Hayley Davis helped their patient “Gary” with his Type 1 diabetes. Dr. Fossum and Dr. Davis both trained in PGY-1 Community-Based Pharmacy programs before transitioning into their current roles. Together they helped Gary on a new journey in managing his Type 1 diabetes  using a continuous glucose monitoring system linked to his smart phone. One of the major challenges is that Gary is legally blind – a complication of living with Type 1 diabetes for many years. Dr. Fossum reflects on the experience by noting “it was really awesome to see that he was able to...hear his glucose level so that he could manage his diabetes a lot better.” While this is just one example of the impact of the Pharmacotherapy (PCT) team on patient care, these pharmacists impact patient care every day. Through collaborative drug therapy management protocols (CDTMs), the team can effectively assist patients in meeting their clinical and personal goals. Through referral, the PCT team targets patients with diabetes who are not at goal to reduce cardiovascular risk and other complications. The team works with patient assistance programs and the outpatient pharmacies to ensure patients get appropriate, affordable medications and supplies.

State/Federal Connections/Advocacy/Impact:

The South Carolina Pharmacy Practice Act Codes 40-43-30 (29) and 40-43-30 (71) define drug therapy management as the practice of pharmacy which involves the expertise of the pharmacist in a collaborative effort with the practitioner and other health care providers to ensure the highest quality health care services for patients.4 South Carolina laws do not specify any site restrictions, pharmacist qualifications (aside from state licensure), or documentation requirements. The Centers for Disease Control and Prevention and The National Alliance of State Pharmacy Associations also released publications providing guidance on pharmacists participating in collaborative practice agreements (CPAs) and further summarize state specific rules and regulations.5,6 The Board of Pharmacy is not involved in the management or approval of individual CPAs.6 

 

The largest barrier for pharmacists practicing in this interdisciplinary environment is billing and its many intricacies. While billing opportunities have significantly grown over the past few years, it has also become more complicated. As CPAs can be executed in a variety of settings (retail pharmacies, provider clinics, hospital-based clinics, etc.), it is imperative that pharmacists collaborate with revenue integrity and compliance specialists to ensure billing is both permissible and successful for each location. Furthermore, different billing opportunities exist for in person versus remote/telehealth services, and the regulations are ever changing, especially in the setting of the COVID-10 pandemic. For systems that do not have access to specialists within these areas, the task for ensuring compliance is significant and time consuming. Further clarification and simplification must be done to ensure pharmacists are reimbursed for their many contributions to these practice sites.   

 

Despite some of the ongoing issues and barriers listed, the PCT Team continues to innovate. With the growing diabetes population and rapport built with providers, the team has begun collaborating directly with endocrinology to help manage more patients and decrease the time to initial visit.  The PCT team also significantly contributed to the achievement of the MUSC ACO (Accountable Care Organization) A1c goal set by CMS. In meeting this goal, the ACO shares in the savings it achieves for the Medicare program. This resulted in individual payments to over 500 MUSC providers, which is the first-time provider payments that have been distributed to individuals as a direct result of performance in a federal value-based payment reform program at MUSC Health.   

 

tennessee

East Tennessee State University
Gatton College of Pharmacy
and Baggett Pharmacy

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Description of Pharmacy

Baggett Pharmacy is a family-owned independent pharmacy proudly serving the suburban community of Kingston, Tennessee since 1972. This single-location pharmacy serves a population that consists of predominantly commercially insured employees due to nearby major manufacturing and national security complexes, as well as Medicare and Medicaid beneficiaries. Located near the Knoxville, TN metropolitan area, Kingston’s Median Household Income is $57,390 (2019). The pharmacy also services the surrounding rural area outside of Kingston, which is designated as a Medically Underserved Area and is recognized as a Low-Income Population by the United States Health Resources and Services Administration (HRSA). Baggett Pharmacy has an expansive list of service offerings including immunizations, non-sterile compounding, medication synchronization, medication adherence packaging, prescription drug assistance program services, durable medical equipment, COVID-19 testing, and remote patient monitoring. 

About the Pharmacy

Baggett Pharmacy
Kingston, TN  
https://www.baggettpharmacy.com/ 

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Meet the Team
 

Faculty Lead Contact:  

Jessica Robinson, PharmD 

Assistant Professor, East Tennessee State University Bill Gatton College of Pharmacy (ETSU) 

Managing Network Facilitator, CPESN  

 

Pharmacist Lead Contact:  

Ronnie Baggett, PharmD 

Owner, Baggett Pharmacy 

Primary Trainee Member: 

Michelle Rapier, PharmD 

Pharmacy Practice Research Fellow, ETSU 

Secondary Trainee Member: 

Rachel Cutshaw, BS 

PharmD Candidate 2022, ETSU 

PHARMACY STORY

Initial Presentation:

A 64-year-old female patient who fills her medications at Baggett Pharmacy was initially identified as eligible for the pharmacy’s appointment-based model medication synchronization (ABM) service based on the quantity of prescribed chronic medications. While conducting a comprehensive medication review (CMR), the pharmacist identified five prescribed medications for high blood pressure with several missed refills. Upon further evaluation, the patient was referred to the pharmacy’s remote patient monitoring (RPM) service due to uncontrolled high blood pressure.   

 

Select medications at baseline: 

  • Four oral medications for high blood pressure 

  • One transdermal patch for high blood pressure 

  • Additional targets: medications for diabetes, including insulin 

 

Patient Report:

The patient reported: 

  • Uncontrolled high blood pressure, Type 2 diabetes, and overweight 

  • Poor adherence to clonidine patch and carvedilol 

Physical Observation:

No notable physical observations. 

Intervention:

Appointment-Based Model Medication Synchronization: 

  • The patient was enrolled in the pharmacy’s ABM service, which includes medication reconciliation and monthly adherence calls.  

 

Remote Patient Monitoring Enrollment: 

  • The patient met eligibility criteria and consented to begin RPM services for high blood pressure management. She agreed to provide blood pressure readings for a minimum of 16 calendar days each month, as is required for the program.  

  • Upon providing consent, the prescribing physician was granted access to the patient’s records within the pharmacy’s RPM platform. Both pharmacist and physician have full access to patient records.  

  • The patient was provided with a wireless blood pressure monitoring device that connects to the RPM platform, allowing the patient to report each blood pressure reading to the shared portal using cell phone data. The portal shows a log of blood pressure measurements taken by the patient in real-time. The device is provided free of charge to the patient by the RPM platform. The device is shipped to the pharmacy for initial setup and delivery by pharmacy staff. 

 

RPM Service Follow-Up:  

  • The patient is contacted weekly by the pharmacist to discuss recent and overall blood pressure trends, and to educate on strategies to improve blood pressure, diet, and overall health. Encounters are conducted by phone and last for approximately five minutes. Each encounter is recorded in the shared RPM portal for review by the prescribing physician. Encounter length (minutes) is tracked in the RPM portal.  

 

RPM Billing: 

  • The pharmacist is credentialed and contracted as a provider to bill the patient’s commercial medical insurance for RPM setup and monthly service fees. 

  • RPM billing criteria include patient and prescriber consent, blood pressure readings on ≥ 16 days per calendar month, and that the provider (pharmacist) spend ≥ 20 minutes per calendar month providing disease monitoring and education.  

  • If these criteria are met, the pharmacist bills a monthly RPM service fee through the patient’s commercial medical insurance. Additional time-based codes are available if more than 20 minutes of service are provided within a calendar month. 

  • The pharmacy uses a medical billing service for RPM billing, but manual billing options are available.  

Outcomes of Care Provided:

Outcome 1: Increased engagement with the healthcare team 

  • The pharmacist has provided weekly RPM services to this patient for a period of six (6) months. Weekly discussions improved the patient’s engagement with her pharmacy team and awareness of her treatment plan. Related discussions and education include diet, weight management, physical activity, and how these strategies can impact overall chronic disease burden (e.g., stroke risk, diabetes progression). The pharmacist referred the patient to a dietician for further consultation outside the scope of RPM. 

 

Outcome 2: Decreased Blood Pressure and Heart rate 

  • Since starting the remote patient monitoring program, the patient has been able to reduce her average blood pressure and heart rate from baseline.  

  • The patient’s average vitals over six months of RPM enrollment are as follows: 

  • Month 0 (Baseline): 

  • Blood pressure: 151/95 mmHg 

  • Heart rate: 92 bpm 

  • Month 6 (Current): 

  • Blood pressure: 141/92 mmHg 

  • Heart rate: 83 bpm

Outcome 3: Increased Medication Adherence  

  • The patient is now adherent to her antihypertensive medication regimen and receives continued coaching during weekly discussions with the pharmacist. 

 

Outcome 4: Decreased weight 

  • Since starting the remote patient monitoring program, the patient reported losing 23 pounds.  

  • The patient has increased physical activity and joined a local Silver Sneakers exercise program. 

  • The patient has decreased meal portion size after discussing with pharmacist and dietician.  

Outcome 5: Decreased need for a medication 

  • Since starting the remote patient monitoring program, the patient was able to reduce and ultimately discontinue fast-acting mealtime insulin. 

  • The patient also switched to a Dexcom continuous glucose monitoring device to help her better track her blood glucose. 

Outcome to the Pharmacy: 

  • Under Tennessee state provider status, pharmacists may bill for services rendered under the RPM program. RPM is a sustainable non-dispensing source of pharmacy revenue.  

  • The learnings and success of the RPM program has opened the opportunity for greater impact on chronic disease management, public health initiatives, and integrates the pharmacist as a key member of the patient’s interprofessional care team.

State/Federal Connections/Advocacy/Impact:

Tennessee pharmacists were formally recognized as providers with the passage of “Pharmacists as Providers” (HB 405/SB 461) legislation in 2017. Since that time, pharmacists like Ronnie Baggett have been able to develop sustainable and impactful services for commercially- and Medicaid-insured patients. Evidenced through positive patient outcomes and decreased drug costs, the Remote Patient Monitoring service is poised to reach a higher standard of patient care in rural areas of Tennessee. Expanding provider status to the federal level would allow pharmacists to provide cost-saving services to Medicare beneficiaries, who are impacted the most by polypharmacy, limited access to health care providers, and lack of expert care coordination. 

 

Lipscomb University College of Pharmacy and Gibbs Pharmacy 

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Description of Pharmacy

Gibbs Pharmacy is an independent, community pharmacy practice that has served members of the community since opening in 1989 in Lebanon, TN. The populations served by the practice site predominantly include suburban and rural residents within Lebanon, TN and surrounding counties such as Wilson, Rutherford, and Trousdale. Gibbs Pharmacy provides a variety of services including medication synchronization, immunizations, compounding, medication therapy management (MTM), medication delivery, long-term care, diabetic shoe fittings, diabetes education, medication disposal, and personal-pill-packaging. Other unique services currently offered at Gibbs Pharmacy include a diabetes prevention program, chronic care management in coordination with collaborating physicians, preventative osteoporosis screening and transitions of care services, and Ideal Protein. 

About the Pharmacy

Gibbs Pharmacy
Lebanon, TN
https://www.gibbspharmacy.net/

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Meet the Team
 

Pharmacist Lead Contact: 

Jasmin Valentin

Christiana Orman

Danielle Oliver

PHARMACY STORY

Initial Presentation:

Patient is a 54-year-old female who was contacted for follow-up through the chronic care management program at Gibbs Pharmacy. While conducting a medication review, the patient presented with a chief complaint of COPD flare ups occurring frequently at night, 3 to 4 times per week. These flares resulted in anxiety attacks and frequent rescue inhaler use, affecting her overall quality of life.  

 

Background:

The patient’s doctor had prescribed: 

  • Bevespi Aerosphere and Flovent HFA inhalers to be used for COPD maintenance control 

  • Proventil HFA inhaler is used as needed for additional, breakthrough symptoms 

Patient Report:

The patient reported having frequent symptoms of COPD flares within the evening, causing her to become anxious and resulted in overuse of her rescue inhaler. This affected her ability to sleep throughout the night and her overall quality of life. 

Intervention:

​The pharmacist conducted a medication review to ensure accuracy and completeness. The patient has tried a variety of different inhalers in the past with continued breakthrough COPD symptoms. After reviewing the patient’s current medications and symptoms, the pharmacist contacted the patient’s primary care provider who is also a collaborative practicing provider with Gibbs Pharmacy. The pharmacist recommended the discontinuation of both the Flovent and Bevespi inhaler, replacing them with Trelegy. By replacing both inhalers with Trelegy, it would reduce the patient’s need to use two inhalers and increase medication adherence. The pharmacist also conducted a test claim to ensure the medication would be covered by the patient’s insurance, which was confirmed with no additional copay. The physician accepted the recommendation, and the patient was prescribed the new medication.  

The pharmacist contacted the patient and counseled them to discontinue both the Flovent and Bevespi inhalers, replacing them with the new Trelegy inhaler. The pharmacist spoke to the patient regarding the new inhaler directions, medication adherence, outcomes of care and follow-up. 

Outcomes of Care Provided:

Outcome 1: Cost Savings 

The patient was able to save money by switching to a single inhaler that was certified by the pharmacist to be covered by insurance due to the test claim conducted before-hand.

 

Outcome 1: Adherence 

The patient was also able to reduce the number of medications used for her COPD to promote adherence.  

 

Outcome 3: Pharmacy follow-up 

The pharmacist documented this encounter in the chronic care management platform so chronic care management pharmacists present on the team can view the patient’s progress and continue the patient’s care.  

State/Federal Connections/Advocacy/Impact:

The care provided to the patient was due to the ability for pharmacists to collaborate with healthcare providers in the state of Tennessee under the Board Rule 1140-03-.17. This collaboration allows clinical pharmacists to coordinate with collaborating providers to provide patient care services associated with screening, prevention, therapy management, and other aspects of care as permitted. Community pharmacies are highly accessible points for patient care, which enables pharmacists and other team members to coordinate care between healthcare providers and patients to ensure quality care for those within the community. It is our goal to continue advocating for professional collaboration, expanding the role of pharmacists and the many services we can offer to the community.  

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