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A new community health initiative developed
by Duquesne University’s Mylan
School of Pharmacy will provide ongoing
counsel and support to uninsured families
dealing with chronic health problems
that require multiple medications. This
unique pharmacist-directed wellness and
disease-management program, Duquesne
Medication Management Services, is
aimed at improving patient outcomes.
“Medication management services
include ongoing monitoring of prescribed
therapy, early identification and
resolution of drug-related problems,
and ongoing patient education and
counseling,” explained Dr. John Tomko,
assistant professor of pharmacy practice.
“Pharmacists are considered consultants
and caregivers on the continuum of care.
They collaborate closely with primary
care physicians and other providers to
improve their patient health.”
Last spring, the Mylan School initiated
a program that would help enhance
the preparation of pharmacy students
for this practice. Dr. Tom Mattei, associate
dean of professional programs,
was instrumental in setting up the first
of many relationships with the local
agencies that serve the underserved by
partnering with Catholic Charities to
provide such a practice experience. The
Catholic Charities’ health clinic in downtown
Pittsburgh was established by the
Diocese of Pittsburgh to meet the needs
of underserved working individuals.
This program represents another
University effort to live up to its mission
by serving the community, Mattei said.
Existing pharmacy school programs that
support the medically underserved include
the Spirit of Health van, a mobile
health facility that provides wellness,
disease prevention and management to
Millvale, Carnegie, Bloomfield, South
Side Hilltop and the West End, and the
Academic Research Center for Pharmacy
Care, which provides similar care to the
faculty, staff and students of the University
and, in the near future, residents of
Uptown and the Hill District.
“We matched teams of professionalyear
students with eligible families who
were referred by the clinic’s physician.
The students, under the guidance
of Tomko, meet monthly with their
assigned patients to provide medical
monitoring, counseling and outcomes
management,” Mattei said.
“We are the only pharmacy school that
is providing medication therapy management
services directly to the working
poor,” added Tomko. “While other universities
may offer a similar program in a
limited setting, to their own employees
in their own learning environment, for
example, we are giving our students the
opportunity to apply their knowledge to
a real patient population in a real practice
setting that immediately improves
the quality of life of the family.”
At the clinic, students conducted
histories and physicals, performed appropriate
screening tests, reviewed the
patient’s social and medication history
and assessed how the prescribed treatment
was working.
“We wanted to make sure patients
understand
why they
are taking
their medications,
how to take
them, how
to manage
adverse
reactions,
and
how the
prescribed
treatment will improve their health,”
Tomko said. “In addition, the students
recommended lifestyles changes, such
as diet and exercise, that can make their
medications work better.”
As well as meeting an important community
need, the Medication Management
Services program, currently offered
as an independent study elective, provides
a new learning environment for students.
“By using a family concept, we’ve introduced
dynamics that would not occur
with just one individual,” Tomko said.
“Our students must deal with communication
issues, cultural diversity issues or
transportation issues that this population
brings to the program. The students are
also working as part of an interdisciplinary
team, with the referring physician,
nurse and nurse practitioner as well as
with their own group, so they are learning
managerial tasks as well. They also learn
to prioritize their own time and their
recommendations to their patients.”
In the process, students learn about
Medicare billing, although all medication
management services are provided
at no cost through the program. Though
the teams worked from paper charts
during the first year, a new electronic
charting system will enable them to see
some of the billing process.
The inaugural program, which
matched 21 student teams with 21
families, was considered a success by
students and families alike, and has been
expanded this year. Students reported a
positive change in their self-perceptions
of clinical skills and were also exposed to
areas in which they could improve their
patient care skills.
“The Medication Management Services
program shows students another way to
provide patient care without a drug in
sight by giving patients who have been
struggling with a chronic health care condition
the tools and information they need
to take control of their life,” Mattei said.
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