University of Illinois at Chicago Ambulatory Care Clinic Site Descriptions Antithrombosis Clinic Preceptors Most Common Disease States/Problems Seen General Description of Clinic Edith Nutescu, Aimee Chevalier, Nancy Shapiro, Ann Kuchta, Beatrice Drambarean, Erika Hellenbart, James Lee Major disease states requiring short or long-term anticoagulation therapy including patients s/p major orthopedic surgery, venous thrombosis, ischemic stroke, peripheral vascular disease, atrial fibrillation, various hypercoagulable states. The clinic also sees high risk pregnant patients and pediatric patients in need of anticoagulant therapy. Consults for peri-procedure bridging therapy are also handled. Located in the Outpatient Care Center. This is a Pharmacist Managed Service. Patients are enrolled in clinic by referral from MD. Clinic Days: M – F 9am – 12pm and M – F 1pm – 5pm. Clinic Structure: Patients are seen by appointment only. An average of 35-45 patients are seen in any given full clinic day. Patients are seen in-person in clinic by the pharmacist. The referring MD is consulted in complex cases and in emergent situations. Point of care testing is performed by a full time pharmacy technician. Limited phone follow-up is also done in some cases (< 5% of our patient volume). Diabetes/Endocrinology Clinic Preceptor Most Common Disease States/Problems Seen General Description of Clinic Daphne Smith Marsh, Shiyun Kim Diabetes Located in the OCC (Outpatient Care Center) Service is provided within the Diabetes Wellness Education Program/Endocrinology Clinic Clinic day: Friday, 9:00 a.m.-4:30 p.m. Clinic structure: The pharmacist provides diabetes education through classes and individual appointments. Pharmacist is involved in the co-management of diabetes with endocrinologists through the initiation and titration of medications. Educational service is part of an American Diabetes Association (ADA) recognized program. Dialysis (Hemodialysis, Peritoneal Dialysis and Renal Hypertension Clinic) Preceptors Most Common Disease States/Problems Seen General Description of Clinic Cheryl Gilmartin The focus of care is on hypertension, diabetes, anemia and hyperparathyroidism. Located next door to the OCC. Pharmaceutical care is provided as part of a multidisciplinary team rounding for three different shifts of patients on a daily basis. The services include both a MTMS program and medication assistance program for patients with chronic kidney disease. Therapeutic drug monitoring is also provided for antibiotics, warfarin, digoxin, and levothyroxine. Continuity of care is provided between dialysis unit, the pharmacy, various UIC clinics and the hospital. Digestive Diseases and Liver Clinic Preceptors Most Common Disease States/Problems Seen General Description of Clinic Michelle Martin Hepatitis, constipation, diarrhea, inflammatory bowel disease. Located in the Outpatient Care Center. Patients are seen by appointment. Patients are seen by pharmacist alone and then presented to the provider. Also respond to Last saved by Gummert, Christopher 2/12/2016 frequent phone calls from patients and pharmacies. Obtain pre-authorization for GI/Liver medications. Electrophysiology Clinic Preceptor Most Common Disease States/Problems Seen General Description of Clinic Jessica Tilton A.Fib, A.Flutter, AT, VT, VT, HTN, Heart Failure, anticoagulation issues. Location: Outpatient Care Center Clinic Days: Wednesday afternoon, Friday afternoon Clinic Structure: EP clinic is a physician run clinic that works as a multi-disciplinary team with a MD, ANP, RN and pharmacist. Patients are seen by the pharmacist based on need identified by the physician, nurse and pharmacist. It is a busy clinic, where the pharmacist practices with a lot of autonomy to create a therapeutic plan that is presented to the attending. Emergency Department Preceptor Most Common Disease States/Problems Seen General Description of Clinic Renee Petzel Gimbar Multiple This rotation is designed to expose residents to the various roles of a clinical pharmacist in an ED setting. The ED sees approximately 55,000 adult and pediatric patients annually. The healthcare team in the ED is comprised of medical students and residents, nurses, nurse practitioners, social workers, attending physicians and clinical pharmacists. This rotation setting is very unique due to direct involvement with medical decision making, drug evaluation and administration to ED patients. The rotation can be very challenging due to the dynamic ED setting and the need to manage multiple problems simultaneously, often making clinical decisions in a very rapid fashion. The degree to which a resident participates as a member of the health care team dictates the type of experience they will have. Family Medicine Center Preceptors Most Common Disease States/Problems Seen General Description of Clinic Louise Parent-Stevens, Marlowe Djuric Kahlic, Rebecca Stone Asthma, HTN, Diabetes, Hyperlipidemia, Hormone management (OCPs/PlanB/Postmenopausal Tx), Anticoagulation management, Smoking cessation, Traveler’s Health, Medication management, Latent TB management, and Assisting patients with insurance/patient medication assistance issues Located in University Village (722 W. Maxwell Street) and OCC. Patients are seen by appointment or as drops-ins/consults. Patients may be scheduled with the pharmacist alone or may be seen at request of MD for consultation. Also respond to frequent phone calls from patients and pharmacies. Heart Failure Preceptor Most Common Disease States/Problems Seen General Description of Clinic Vicki Groo Heart Failure, HTN, CAD, hyperlipidemia, renal insufficiency, diabetes, atrial fibrillation, anticoagulation Located in the OCC. Clinic meets 2 days per week from 7:30 a.m. until 1 or 2 pm. Resident will work side-by side with preceptor, fellow, and attending. Pharmacist sees patient first and presents history and assessment to MD with goal of contributing to the treatment plan. Will be involved in taking medication history, symptom assessment, self care assessment, patient education, development of Last saved by Gummert, Christopher 2/12/2016 treatment and monitoring plan. Residents who choose to do a concentrated month of cardiology will also have the opportunity to do phone follow-ups, laboratory monitoring and participate in a pharmacist run medication titration clinic. Infectious Disease and HIV (Family Center for Infectious Disease) Preceptors Most Common Disease States/Problems Seen General Description of Clinic Renata Smith, Rodrigo Burgos, Melissa Badowski HIV/AIDS and its complications, other co-morbidities in the setting of HIV: hypertension, DM, asthma, dyslipidemias, pregnancy, STDs, and co-infection with hepatitis and HIV. Located in the OCC building Room 3. Patients are seen by appointment or as walkin. The clinic has a multidisciplinary approach to patient care and pharmacists will interact with various healthcare professionals as part of the day to day activities. Patients may be seen just by the pharmacist or as part of their routine care visit. Pharmacists play an active role in patient care activities including: obtaining medication history, medication education and adherence monitoring, review of antiretroviral resistance testing, selection of antiretroviral therapy, comorbid disease state evaluation, management of adverse drug reactions and drug-drug interactions, prescription refills and the coordination of Illinois ADAP clients medications. In addition, a subset of patients will have pre-determined visits for pillbox fillings. Infectious Disease and HIV (IDOC Telemedicine) Preceptors Most Common Disease States/Problems Seen General Description of Clinic Melissa Badowski HIV/AIDS and its complications, other co-morbidities in the setting of HIV: hypertension, DM, asthma, dyslipidemias, pregnancy, STDs, and co-infection with hepatitis and HIV. Located in the Benjamin Goldberg Research Center at the University of Illinois at Chicago campus. The telemedicine program implements a multidisciplinary approach to provide HIV care while a prisoner is incarcerated. An infectious disease physician, an infectious disease clinical pharmacist, and case manager provide HIV care to 26 prisons within the state of Illinois. An entire clinic visit is performed through telecommunications without leaving the UIC campus. With the use of a computer and video-equipment, we are able to see each patient and conduct an entire clinic visit. Pharmacists play an active role in patient care activities including: medication education and adherence counseling, review of antiretroviral resistance testing, selection of antiretroviral therapy, comorbid disease state evaluation, management of adverse drug reactions and drug-drug interactions, and prescription order entry. Medication Therapy Management (MTM) Clinic Preceptors Most Common Disease States/Problems Seen General Description of Clinic Jessica Tilton, Shiyun Kim, Anna Markel Vaysman, Daphne Smith Marsh, Lori Wilken, Tiffany Scott Horton, Mansi Shah Most common disease states are HTN, hyperlipidemia, DM, stroke, asthma/COPD, heart failure. Health care issues include medication related problems involving nonadherence, decreased continuity of care, medication reconciliation, adverse drug events and low health literacy. Located in the OCC (Outpatient care center). A referral based pharmacy managed clinic. Clinic days: Monday-Friday, 9:00 a.m.-4:30 p.m. Clinic structure: Patients are seen primarily by appointment. The clinic can average 10-24 patient visits per day. Services provided include disease state management, assistance in medication access and adherence, continuity of care, monitoring for drug efficacy, drug related problems and education. Last saved by Gummert, Christopher 2/12/2016 Neurology Clinic Preceptor Most Common Disease States/Problems Seen General Description of Clinic Mitra Habibi Adult epilepsy and Pediatric general neurology. Located in the OCC. Patients are seen by appointment. The resident will become part of the outpatient Neurology team which consists of an attending, 1-2 neurology residents/fellow and a PharmD. Patients are seen by pharmacist independently and then presented to the attending; they will be involved in the final assessment and plan. If bloodwork and specifically AED levels are ordered for a patient during their clinic visit, the results are followed-up, discussed with the attending and dose adjustments are made if necessary. Oncology Clinic Preceptors Most Common Disease States/Problems Seen General Description of Clinic Sandy Cuellar Puri, Scott Wirth Solid Tumors, Hematological Malignancies, Chemotherapy-Related Toxicities, Nausea/ Vomiting Management, Electrolyte Replacement, Pain Management, Drug Information Consultation Located in the Outpatient Care Center. Patients are seen daily for outpatient chemotherapy. Patients are also seen for follow-up with their hematologist/ oncologist. Clinical Pharmacists are consulted for supportive care management and general oncology/ hematology drug consultation. Pain Preceptor Most Common Disease States/Problems Seen General Description of Clinic Julie Golembiewski Low back pain, diabetic neuropathy, fibromyalgia, radiculopathy, and other types of chronic non-cancer pain Located in the Outpatient Care Center. Patients are seen by appointment or as consults. Patients are seen by the pharmacist with a pain fellow or anesthesia resident and then presented to the attending. Pharmacist is specifically asked to see patients returning to the clinic for medication refills, not patients who are at the clinic for evaluation of their pain or for a procedure to relieve their pain. Pediatrics (Children & Adolescent Center and Family Center for Infectious Disease) Preceptor Most Common Disease States/Problems Seen General Description of Clinic Leslie Briars, Kirsten Ohler, Lauren Dandeles, Donna Kraus Most of the patients are followed for well child care (e.g., immunizations) or chronic disorders (e.g., asthma, attention deficit disorder, atopic dermatitis, oral contraceptive use) & some are for acute care (e.g., R/O sepsis, lead poisoning, STDs, otitis media, pharyngitis, asthma exacerbation). Some of the specialty clinics that pharmacy provides services for include nephrology & HIV. Located in the Outpatient Care Center. Pharmacy services in all of the areas include: medication histories, assisting with choosing appropriate therapeutic regimens, suggesting monitoring parameters to follow & medication education. The majority of the pharmacist’s interventions include education to the family, patient and practitioner seeing the patient. Other services provided include: drug information, conferences to residents/interns & provision of continuity of care. Patients are seen along with the physician/practitioner and multidisciplinary rounds are attended as scheduled for nephrology and HIV. Last saved by Gummert, Christopher 2/12/2016 Psychosis Clinic Preceptors General Description of Clinic Shiyun Kim, PharmD., CDE & Jeff Bishop, PharmD., BCPP The resident will participate in a collaborative practice in outpatient psychiatrypsychosis clinic. Responsibilities include but are not limited to the following: 1. Conduct an interview for compliance, and side-effect assessment 2. Assess patient chief complaints/signs/symptoms and possible etiologies (psychiatric/neurological/medical) 3. Monitor patients on Clozapine and coordinate the care with the psychosis team 4. Administer Long-Acting Injection Antipsychotic agent as prescribed by the psychosis team and monitor patients for efficacy, side-effects and compliance 5. Review and discuss major psychiatric diagnosis and treatments options with the psychosis team 6. Participate in teaching rounds at the end of each clinic day 7. Participate Clozapine Support Group Psychosis Clinic location: NPI (Neuropsychiatric Institute), 5th floor, 912 S. Wood Street Pulmonary Clinic Preceptor Most Common Disease States/Problems Seen Lori Wilken COPD, Tobacco dependence, Moderate and severe persistent asthma, Pulmonary hypertension, Allergic rhinitis, Allergic bronchopulmonary aspergillosis, Sarcoidosis, Interstitial lung disease, Pulmonary embolism, Obstructive sleep apnea Located in the Outpatient Care Center 3C. Patients are seen before or after being seen by the pulmonary fellow. Medication reconciliation, asthma and COPD action plans, asthma and COPD control tests, tobacco dependence consults, inhaler education, drug adjustment recommendations are provided on appropriate patients. General Description of Clinic Tobacco Dependence Center Preceptor Most Common Disease States/Problems Seen Lori Wilken Tobacco dependence. Usually cigarette smokers; rarely cigar and spit tobacco. Special populations with cardiovascular, psych, other addictions, pregnancy, and HIV. Spirometry and carbon monoxide assessments completed at baseline. Located in the Outpatient Care Center 3C. Patients are seen individually by appointment. Patients are seen by pharmacist alone and then presented to the attending, if needed. General Description of Clinic Solid Organ Transplant (Adult) Preceptors Most Common Disease States/Problems Seen General Description of Clinic Maya Campara, Jamie Benken, Beth Hetterman Renal transplant, liver transplant, pancreas transplant, immunosuppression-related toxicities, chronic kidney disease, chronic liver disease, hypertension, diabetes, anemias, hyperlipidemia, infections in immunocompromised host, secondary hyperparathyroidism, electrolyte replacement, pain management, medication adherence. Located in the Eye and Ear Infirmary (Transplant Center). Patients are seen by appointment. Patients are seen by pharmacist alone and then presented to the physician. Telemedicine Hepatitis Clinic Preceptor Juliana Chan Last saved by Gummert, Christopher 2/12/2016 Most Common Disease States/Problems Seen Viral hepatitis C, liver transplantation, co-infected patients with HIV/HCV, Hepatitis B, cirrhosis, Objectives of the rotation The resident will participate in a collaborative practice in outpatient Telemedicine clinic. Responsibilities include but are not limited to the following: 1) To learn how to evaluate a hepatitis C patient for HCV treatment 2) To participate in scholarship activities and/or research projects aimed at treating Liver diseases. 3) To gain exposure to Specialty Pharmacy Services by seeing and treating patients with HCV in the Telemedicine clinic. 4) Provide pharmaceutical are by educating (ie, administration, injection technique) patients with HCV in the Hepatitis C Clinic. 5) To write an article or newsletter for publication General Description of Clinic Located in the Benjamin Goldberg Research Center at the University of Illinois at Chicago campus. Pharmaceutical care is provided as a part of a multidisciplinary team which includes a team of hepatologist and clinical pharmacist. The goals of this rotation are listed above in the ‘objectives of the rotation’. Women’s Health (Center for Women’s Health) Preceptors Most Common Disease States/Problems Seen General Description of Clinic Rebecca Stone High risk OB, Contraception/emergency contraception, STDs and other vaginal infections, urinary tract infections, medication use in pregnancy and lactation, gestational diabetes, smoking cessation and asthma in pregnancy, menopause Located in the Outpatient Care Center. Patients are seen as drops-ins/consults. High risk OB patients are screened by the pharmacist independently for medication/vaccine issues and then presented to the provider and administer vaccines, if needed. The PharmD also provides patient education including gestational diabetes new patient education, insulin teaching, asthma action plans, LMWH teaching, etc. Additional responsibilities include refill/prior authorization requests, and drug information questions from both providers and patients. Last saved by Gummert, Christopher 2/12/2016