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Elective Advanced Pharmacy Practice Experiences
Medication Management in Xicotepec, Mexico
College of Pharmacy, Iowa City and Xicotepec, Mexico
Preceptor(s) Hazel H. Seaba, M.S., Christine M. Catney, Pharm.D.
e-mail: hazel-seaba@uiowa.edu
Phone: 319-335-9241; Fax: 319-335-8079
Description of the practice experience:
An international medication management rotation with focus on medication access disparities in Xicotepec, Mexico. Students will receive training in public health topics including medication access management issues of countries with disparities. Students, through problem based learning assignments, will develop an information package about the area, create an Activity Plan for their week in Xicotepec, (set goals, establish activities, determine assessment criteria). One week will be spent in Xicotepec executing the Activity Plan. The on-site experience is offered within the Rotary International Xicotepec Project. Upon return, students will assess their experience, their contribution to the Rotary project and their contribution to improved health care in Xicotepec. Recommendations for future Xicotepec rotation activity plans will be made.
Prerequisites:
P4 standing, valid passport, international health insurance, acceptance of Rotary conditions of participation. Student is responsible for travel expenses to and from Xicotepec, but not local housing or meals (exception: two lunches and two dinners).
Strongly encouraged, but not required: 46:377 Introduction to Health Disparities and Culturally Competent Care.
NOTE: student must be available for both cycle 8 and 9. This rotation will be taught February 18 – March 21, 2007. March 8-16 will be in Xicotepec, Mexico. Student can either enroll for this rotation and a bye or enroll for this rotation and a research rotation with H Seaba.
Proteus Migrant Health Project
Des Moines Central Office Muscatine Area Office
3850 Merle Hay Road, Suite 500 128 East 2nd Street, Suite A
Des Moines, IA 50310 Muscatine, IA 52761
Phone 515-271-5303 563-264-0880
Toll Free 800-372-6031 800-397-9675
Fax 515-271-5309 563-264-0882
Precepotor(s) Bob Witt, PA/Clinical Director Sara Quintero-Dickey, LPN
e-mail bobw@proteusinc.net saraq@proteusinc.net
Description of the practice experience:
Proteus Migrant Health Project is a private, non-profit 501(c)(3) corporation funded by grants from the Federal Health Resources and Services Administration and the Iowa Department of Public Health to provide medical outreach, health care services to migrant farm workers and their families. Proteus utilizes a unique, PA/Voucher model which assists eligible patients in accessing primary health care through outreach clinics, worksite and home visits, or referrals to contracted local community health providers (including area pharmacies, medical clinics, dentists, optometrists, etc.). Patients seen are typically Latino, of lower socioeconomic and educational status, non-fluent in English and may range in age from newborn to elderly although young adult and middle-age males are more the norm. Health screenings consisting of detailed health histories, height-weight-vision screens, vital signs and comprehensive physical examinations are completed on each patient seen. Among the more common medical problems encountered each year are: hypertension, diabetes, hyperlipidemia, various dermatoses, musculoskeletal disorders and repetitive injuries, diarrhea and acute illnesses. Clinic outreach scheduling is oftentimes done only a few days in advance and the vast majority of clinics are held during the late afternoon and evening hours throughout the state. It is not uncommon to travel 1-2 hours to a clinic site or to occasionally work outside. Portable exam tables, privacy screens, patient charts, supplies, medications and CLIA waived lab tests (including dipstick UAs and pregnancy tests, glucometer and HbgA1C screens, lipid panels, hemoglobins and rapid strep screens) are all transported in company vans to each of the clinic sites. Proteus contracts with 1-2 licensed PAs each summer who function as the primary healthcare providers. Numerous medical students and PA students are present during regular rotations throughout the summer months along with many “volunteer” physicians, nurses and public health students. Pharmacy students would be an integral part of this health care team and would be provided the opportunity to: help optimize patient drug therapy, provide needed drug education to individual patients and counsel identified patients on smoking cessation, hypertension and diabetes in their native language, help identify commonly-used medications purchased by patients in Mexico, sign patients up for Patient Prescription Assistance Programs, assist in the dispensing, recording and monitoring of selected prescription and non-prescription sample medications given out to patients, assist in the administration of adult tetanus immunizations and the performance of laboratory tests, provide brief pharmacotherapy presentations to other team members and students while traveling to clinic sites as well as researching drug information questions and making recommendations on patient drug-regimens, and limited interpretation for health care providers who may not be bilingual.
ABERDEEN AREA INDIAN HEALTH SERVICE PHARMACY ROTATIONS
The Aberdeen Area Indian Health Service provides ambulatory care/hospital rotations at several of their facilities.
Below is a list of sites that offer rotations. If you are interested in an Indian Health Service Rotation in this area
contact the Aberdeen Area Pharmacy Consultant:
Cpt Michael Forman
605-226-7212
605-226-7508 Fax
mforman@abr.ihs.gov
Management Sciences for Health (MSH) Center for Pharmaceutical Management (CPM)
4301 North Fairfax Drive, Suite #400
Arlington, VA 22203
Preceptor(s) Keith W. Johnson, M.S. e-mail: kjohnson@msh.org
Phone: 703-524-6575 (general); 703-248-1609 (direct) Fax: 703-524-7898
Practice site web site: www.msh.org (select Pharmaceutical Management and then Programs)
Description of the practice experience:
The MSH Center for Pharmaceutical Management’s practice experience program provides students with the
opportunity to learn about best practices for pharmaceutical management and approaches to enhancing access to and
appropriate use of medicines in underserved and resource-limited environments (both developing country and
domestic). The student also learns about international health development programs and organizations (e.g., WHO,
USAID, PAHO), the role of non-governmental organizations in improving health care services and outcomes, and
the potential for contributions by pharmacy training institutions, pharmacy organizations, and individual
pharmacists. Working with CPM staff, students delve into issues affecting access and use of medicines for a specific
country or underserved area and for a specific issue and/or disease (e.g., HIV/AIDS, TB, malaria) or target
population (e.g., children, mothers). The result of this work will be a draft document that provides a
situational/options analysis, set of policy recommendations, or intervention strategy/work plan relating to the issues
and country studied. Examples of topics that may be addressed include child/maternal health, pharmaceutical
services, medicines quality/safety, medicines use (e.g., rational prescribing, patient adherence), behavioral change
strategies, cultural biases/barriers to access, financing/health insurance, drug regulation, information access and use,
pharmacovigilance, etc. – all within the context of a particular country or underserved population. A specific scope
of work will be negotiated with each student at the beginning of their rotation based on individual interests
and on the availability of specific projects, country linkages, and technical staff to serve as resources.
Normal work hours for the student – 8:30 a.m.-5:00 p.m. Monday-Friday
Exceptions to the above time frame – Holidays; important meetings that may run past 5 p.m. or that are scheduled
for Saturdays (rare occurrence)
Other pertinent information the student needs to know – MSH Arlington offices are located in the Ballston area of
Arlington, Virginia, and are one block away from the Ballston station on the Washington Metro Orange Line.
Housing not provided or available through MSH; however, local resource information on where to look for housing is available by contacting Jane Andelman (jandelman@msh.org).
Zuni Comprehensive Community Health Center
Preceptor(s): Thang La, Pharm.D.
Lu Del Livingston (White), R.Ph.
Tom Horeis, Pharm.D.
Peter Diak, Pharm.D.
Timothy Lape, Pharm.D.
Description of practice experience:
We serve the Zuni Pueblo Tribe as well as members of the Navajo tribe that live in the area. Our main focus is to provide comprehensive health care to our patient population. Care is provided for diabetes, renal clinic, and ambulatory care as well as other part time clinics. Students will have the opportunity to observe the treatment of many disease states. We also have a 30 bed inpatient in which students may have the opportunity for anti-coagulation, renal care, tobacco cessation and podiatry.
Other pertinent information: There are many things to do in the area such as hiking, biking, site seeing as well as an opportunity to experience the culture.
Normal work hours for the student: Monday-Friday, 8:00 AM to 5:00 PM
Exceptions to the above time frame: Our hours of operation are 8:00 AM - 5:30 PM and weekends until 5 PM, so the students have time to work overtime on projects to make extra time to explore the area.
Housing: A student trailer is provided at no cost when students arrive. The students will be responsible for their own meals, the trailer is equipped with a kitchen and utensils. There are stores to purchase food nearby.
Santa Fe Indian Hospital
Preceptor(s): Gina Jorgenson, Pharm.D.
David E. Kuhl, Pharm.D.
Cornelius Dial
Description of practice experience:
We serve approximately 16,000 Native Americans from 12 tribes in New Mexico. Our hospital provides a wide range of comprehensive health care in addition to general ambulatory patient care and inpatient services for example: dental, environmental health, occupational therapy, substance abuse, rehabilitation, social services, nutrition, optometry, mental health, etc. Our main emphasis in our ambulatory care pharmacy is management of chronic diseases for example, diabetes, hypertension/chronic renal pts, dyslipidemias, and asthma. This is in addition to all our ambulatory/acute care patients. We would like our students to become familiar with the most current guidelines for management of these diseases and become adept at applying this knowledge to our patients. They will have the opportunity to work in a lipid (cardiovascular) clinic with a pharmacist practitioner, diabetes clinic with our diabetes pharmacist, and renal clinic.
Normal work hours for the student: 8:00 AM to 5:00 PM, Monday - Friday (1 hour lunch break)
Other pertinent information: If a student is placed at our site, we will send out a packet of information and documents which will need to be completed and sent back to us AT LEAST 1 month before expected start of rotation. If we do not get this in time, the student will not be allowed to work at SFIH, therefore, this is extremely important. If the students have any questions, they are welcome to call me at any time and I’ll try to help them all I can - even questions about our site/what to expect etc.
Please note: Prior approval is required for this site, since the site takes students from several schools of pharmacy. Students will be selected on first come, first serve basis. The experience at the Santa Fe Indian Hospital may be a 5 week or 10 week experience. If a student selects a 10 week experience, one five-week period will be in drug information and the other in ambulatory care.
Community Health Care, Inc. in Davenport
Description of practice experience:
Our pharmacy is located within Community Health Care, Inc. or CHC, which was founded in 1975, to offer a medical and dental home for persons who could not access primary health care elsewhere in the community. CHC offers preventive, acute and chronic care, as well as laboratory, x-ray, pharmacy, nutrition, and health education services. Without CHC, many patients would rely on emergency rooms during crisis, or go without care altogether. CHC accepts all patients who are in need who may not be able to access primary health care elsewhere in the community for financial, social, medical or cultural reasons. Our pharmacy is able to pass savings on to our patients through 340B discounted priced medications. We accept most Medicare Part D prescription plans and have a full-time resource specialist on staff to assist patients with enrollment in various pharmaceutical patient assistance programs. Students will work 40 hours per week and should be self-motivated, have great customer service skills, and be an effective communicator. The student will be involved in: over-the-counter and prescription counseling; prepare and present informal and formal educational programs to physicians and other medical/dental staff; participate in medication reconciliation and education with our adult, pediatric, obstetrics, gynecology, and homeless populations while shadowing our physicians, physician assistants, and advanced nurse practitioners; travel with Homeless Team to various shelters, clinics, etc. where health care is provided; participate in our diabetic and cardiovascular collaboratives; assist patients in registration and education of pharmaceutical patient assistance programs.
People’s Clinic Pharmacy in Waterloo
Description of practice experience:
People’s Pharmacy is part of a federally qualified healthcare clinic. Special populations served includes Bosnian, Hispanic, African American and the medically underserved in the Cedar Valley area. Currently, pharmaceutical care clinics include: anticoagulation clinic, lipid clinic, and asthma clinic. General review of medications and education regarding hypertension. Special challenges include language barriers, diverse educational levels, diverse cultures, and cost constraints for patients. This pharmacy dispenses samples and runs an indigent medication program.
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