As Fairview patient Barb Davis prepares for her clinic visit, she pulls out a folded piece of paper. On it is a printed list of each of her prescriptions—an incomprehensible catalog of medications, milligrams and five-syllable ingredients.
Below each medication on the list, however, there is a neat, handwritten note explaining, in plain language, its purpose.
These notes help Barb understand not only what she’s taking, but why. It’s a small but compassionate gesture, courtesy of Hannah Nici, medication therapy management pharmacist. Hannah works one-on-one with Barb to help her manage her medications and achieve her health goals. With a number of challenging medical conditions and more than a dozen medications, Barb is grateful to have Hannah to rely on for guidance and support.
“Hannah is like my right arm,” Barb says. “We’re so connected.”
Hannah talks with Barb about how much she’s taking of each medication, the progress she’s made and any side effects she may be experiencing, and then makes adjustments as needed.
“I can call her and say ‘this pill isn’t working’ and she knows what to do,” says Barb.
Hannah meets with Barb regularly, and is able to devote more time and individualized attention to her than a typical pharmacist. This helps the two of them not only work through problems more thoroughly, but also form a personal, trusting relationship.
“She’s been there for me and she knows me,” says Barb. “That means everything.”
Offering patients the support they need to achieve their health goals is one way we’re driving a healthier future.
“Brittany has been a lifesaver in many ways,” says Anita, 67. Anita’s multiple chronic diseases and related complications had created barriers to care and landed her in the hospital. She needed specialized help to get her health back on track.
That’s where Brittany Symonds, Medication Therapy Management pharmacist, Fairview Physician Associates (FPA) Network, stepped in. She serves as part of a network team that came together to help Anita.
“Talking to Brittany and getting my medications straightened out has been important,” says Anita. “I don’t think it would have been possible without her help.”
Diabetes diagnosis brings difficult new reality
Anita was used to being active. She worked locally for 35 years until back surgery and a hip replacement caused her to retire. A diagnosis of diabetes during a hospital stay last December sent her health into a downward spiral.
The problem began when she tried to renew the diabetes medication after a post-hospital rehabilitation stay. Because of mobility limitations, Anita was not able to see her physician, David Brockway, MD, Richfield Medical Group. She went without her medication for several months.
“My blood sugar went sky high,” says Anita. “I ended up back in the hospital.”
In addition to Brockway and Symonds, Anita’s team included Shannon Whalen-Saraswate, Fairview clinical product navigator.
The Perfect Storm
“After a particularly difficult hospitalization, Fairview’s navigator identified her as a high-risk patient and reached out to our clinic care coordinator,” says Brockway.
FPA Network care coordinators work with patients of independent member clinics. As registered nurses and social workers, they serve as part of a team to address such barriers as complex medical care, psychosocial problems and social service needs.
“In cases like Anita’s, we just have to chip away at the details until we uncover the real reason for the problem,” says Melody Anderson, RN, FPA Network care coordinator.
For Anita, multiple factors conspired to create what Symonds called “a perfect storm.” Barriers to care included medication cost and mobility issues preventing Anita from visiting her doctor. Symonds worked with Anita by phone, reducing the number of clinic visits needed, and helped her find less expensive medications through a mail-order source.
Care coordination and MTM—“the best things”
Anita calls care coordination and medication therapy management “one of the best things Fairview instituted. If I hadn’t had Brittany, I don’t think I’d have my diabetes under control and feel as well as I do today.”
For more about care coordination, contact Karen Mulder, RN, FPA director, network clinical services, firstname.lastname@example.org.
"I Owe a Large Part of My Future to Fairview"
I’ve had Type 1 diabetes since I was 19 years old. I thought I was taking proper care of myself, but I’d often experience extremely low glucose levels.
A few years ago, my Fairview nurse practitioner recommended I schedule an appointment with a Medication Therapy Management (MTM) pharmacist. It was the same thing my Fairview retail pharmacist had been saying so I decided to give it a try.
The MTM pharmacist, Paull Rukavina, spent a whole hour talking with me. He gave me a new glucose monitor and made sure I understood the importance of testing my levels regularly.
Later, Paull recommended I start using an insulin pump. I refused, thinking it would be the final step in losing control of
my life. But, when the inhaled insulin I was using was discontinued, I talked with Paull and my nurse practitioner and decided to start using a pump.
It was a turning point in my life: within a few months, I was able to get my diabetes to a controlled stage.
I owe a large part of my future to Fairview MTM and the time, effort and dedication that Paull put into my case for 18 months. It’s the main reason I am now controlling the diabetes and it is not controlling me.
I am thankful that my daughters will not have to spend their childhoods watching their father’s health fail due to diabetes. And I can’t thank Paull enough for taking the time to listen to me and work the diabetes around my lifestyle, instead of making me work my life around diabetes.
As patients take more prescriptions from multiple providers and specialists, having an expert who's able to look at the patient’s whole medication picture, and has time to answer every question, is invaluable.
That’s why Pamela Noll, DO, a primary care provider at the Fairview Clinic in Uptown, referred lanne Pearson to Medication Therapy Management pharmacist Allyson Schlichte.
“There’s so much to know regarding medications,” says Dr. Noll. “As it gets more complex, these pharmacists are a great resource for patients. I can’t overstate the value they bring.”
When Dr. Noll referred Ianne Pearson, Ianne was in a continuous cycle of sickness. Regular bouts of bronchitis would aggravate her asthma, yet the medications to treat her asthma would complicate her diabetes symptoms. Ianne says working with Allyson helped her stabilize her health and be the person she wants to be.
“Allyson helps control things; she helps me maximize the meds I’m taking and minimize the problems that come with them,” Ianne says. “Allyson makes sure I know what each medication is doing and why it’s important, and how they work together. I know Allyson and Dr. Noll are working together on things, and it’s reassuring. I feel protected.”