Working Without a Net

Working Without a Net

USC School of Pharmacy Newsletter, January 1, 2004
By Alexis Bergen

In the wake of Los Angeles County’s health-care crisis, community-based clinics have become increasingly important for some 2.7 million uninsured residents who rely on the “health-care safety net.”

This safety net of non-profit clinics deliver medical services and health education to low-income patients, regardless of their ability to pay. Clinics receive limited funding from Los Angeles County and rely on private donations and other government funds. According to the California Office of Statewide Health Planning and Development, the county’s safety net clinics serve more than 600,000 patients annually; almost 70 percent of their patients have no health-care coverage.

Amidst staff burnout and scarce resources, safety net providers struggle to provide comprehensive primary care to these underserved patients.

To help meet this need, faculty members in the community pharmacy program at the USC School of Pharmacy have developed pharmaceutical services at three local clinics to increase patient access to affordable medications and disease management.

Participating clinics include the To Help Everyone (T.H.E.) Clinic, Inc. and the South Central Family Health Center (SCFHC), which serve low-income families in south and central Los Angeles, and the Weingart Medical Clinic, which serves the homeless community in downtown Los Angeles’ skid row area.

“Safety net clinics are understaffed and support for pharmaceutical services is essential for more effective and efficient care,” says Melvin Baron, Pharm.D., associate professor of clinical pharmacy, USC School of Pharmacy. “By providing regular health maintenance, pharmaceutical services will decrease hospitalizations and mortality rates over time.”

Pharmaceutical care services include monitoring patients with chronic diseases such as diabetes, hypertension, asthma, high cholesterol and heart failure, who often take multiple medications for their conditions.

“Many patients don’t understand the need for long-term drug therapy, particularly if their condition is asymptomatic like high cholesterol,” says Steve Chen, Pharm.D., assistant professor of clinical pharmacy, USC School of Pharmacy. “We spend a lot of time educating them about their condition and the importance of continuous therapy.”

Once diagnosed by a physician, patients are referred to a staff pharmacist for assessment and ongoing monitoring of their drug regimen. Staff pharmacists have the authority and expertise to adjust prescribed therapies in order to manage each patient’s disease safely and effectively, Chen says.

“Clinic physicians will identify the hard-to-manage patients from a drug therapy standpoint and let us teach them more about their prescriptions, as well as catch any potential drug interactions,” Baron says.

Funding from a UniHealth Foundation grant will be used to hire an additional full-time pharmacist to float between the clinics and expand the number of disease management programs available to patients, says Kathleen Johnson, Pharm.D., Ph.D., M.P.H., associate professor of clinical pharmacy and pharmaceutical economics and policy, USC School of Pharmacy.

“With supervision by one of our pharmacists, both School of Pharmacy resident pharmacists and students will be certified to administer immunizations, monitor blood pressure, work with diabetic patients and teach asthmatics to get better use from their inhalers,” Baron says.

He adds, “This project is a great opportunity for the USC School of Pharmacy to develop models that can be adopted throughout the country.”