The Pain Clinic The pharmacy based pain clinic was initiated by pharmacists, Don Ahrens and Randy Seys, both whom continue to serve in the Public Health service. Current pharmacists staffing the pain clinic are Stacey Thompson and Seth Moore. Our current clinical medical director is Family Medicine Clinic provider, Dr. Kevin Gaines. The purpose of the Pain Management Clinic at GIMC is to assess, treat, and control chronic pain. Patients may enter the clinic through referral by a GIMC care provider. This allows the pharmacist and doctor to work together and determine an appropriate pain medication regimen and/or discuss possible alternatives such as physical therapy. Educating patients about pain management and their medications is of utmost importance. The pain clinic meets on Thursday afternoons between the hours of 1 to 5 PM and able to accommodate about 8 to 12 patients. Seth Moore-Not in Photo Pharmacy Adherence Clinic is part of the Internal Medicine Infectious Disease Clinic with the purpose of assisting physicians in monitoring adherence to antiretroviral therapy. The clinic is held one afternoon each week. The pharmacists in this clinic provide comprehensive education regarding medication regimens, emphasize the importance of achieving 95% medication adherence rate, monitor medication refills, perform pill counts when needed, and communicate noncompliance to physicians and case managers. Pharmacists are also part of the care conference meetings to coordinate care for individual patients. Other members of the care conferences include a physician, a mental health provider, a nurse and case managers. The Asthma Clinic The asthma clinic had over 90 patient clinic visits last year. We consult with the primary provider in order to optimize the patient’s asthma care. We educate patients to increase their knowledge of asthma. The education is done to help control each patient’s asthma while hopefully keeping them out of the hospital and from making unwanted visits to the urgent care clinic and emergency department for asthma exacerbations. The clinic was started in the year 2000 by Ray Cope. Ray Branson, Ron Won, and Gabriella Sanchez are the pharmacists currently running the clinic. The Nephrology Clinic The pharmacists work with the nephrologist to maintain nephrology patient’s care. We identify compliance issues and adverse drug reactions. Together with the physician we optimize patients’ medications to give them the best benefit possible. Over 142 patients were seen last year. Over 53% of the patients seen had a therapeutic intervention. In addition, the clinic pharmacists fill medications for all patients receiving dialysis. We dispense medications to over 90 dialysis patients every 60 days. We counsel each patient to help increase drug adherence and educate them on their disease state. The clinic was started in 1998 by Cindy Smith. Ray Branson and Kevin Johnson are the pharmacists who currently run the clinic. The lipid clinic was started around 1999 by Nate Yale & Dr. Richtsmeir and is currently being run by Jacob Van Vleck and Stacey Thompson. The Lipid clinic sees anywhere from 1-9 patients each Monday afternoon. Any patient wishing to participate in the clinic needs a referral from their primary care provider. In the clinic we will talk about each patient’s diet, exercise, medication, and lab values. Some of the most important topics discussed in clinic are healthy eating and exercise and finding ways to improve a patient’s lifestyle. All it takes is a little as 20-30 minutes of exercise 3-4 days a week and minor adjustments in diet to promote a healthy heart & lifestyle. Jacob Van Vleck-Not in Photo The Anticoagulation Clinic started in early 1999 by Cathy Zehrung in conjunction with our cardiologist, Dr. Richtsmeir. Dr. Fronc, our current cardiologist, oversees the clinic. The clinic has approximately 100 patients who are extensively counseled on warfarin. The pharmacists obtain protimes & INR's in the clinic with a point-of-care machine. They also assess for signs & symptoms of over anticoagulation; for signs of blood clots & strokes; and evaluate other factors that can affect the warfarin, such as diet, recent illness, or changes in medications. With this information, the pharmacists determine the patients' warfarin doses. Presently, six pharmacists, Gabriella Sanchez, Jacob Van Vleck, Dana Springer, Ray Cope, Ron Won, and Vicky Chavez work in the Anticoagulation Clinic. Hello, my name is Christine Castillo and I am involved in diabetes education at the Family Medicine Clinic twice monthly (2nd and 4th Tuesdays). Patients are referred to see a diabetes educator by their provider and may need help in learning about insulin use, blood glucose monitors, nutrition and help in lowering their blood sugars. I have been able to help ~25-28 patients per month. This niche came about for me because the diabetes program needed help with coverage and asked if pharmacy could help other diabetic educators. I thoroughly enjoy helping diabetic patients in reaching normal blood sugars and improving their quality of life. I am also able to communicate in Navajo with non-english speaking patients. Being in this clinic has improved my clinical skills in diabetes education and to teach other pharmacy students and residents in this field.