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.