Responding to the Los Angeles County’s health-care crisis, 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.
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 delivers 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.
The clinics now offering pharmaceutical services include the To Help Everyone (T.H.E.) Clinic Inc., and the South Central Family Health Center, which serve low-income families in south-central Los Angeles, and the Weingart Medical Clinic, which serves the homeless community in downtown Los Angeles’ Skid Row area.
“Safety-net clinics are under-staffed and support for pharmaceutical services is essential for more effective and efficient care,” said Melvin Baron, associate professor of clinical 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,” said Steve Chen, assistant professor of clinical 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 to manage each patient’s disease safely and effectively, Chen said.
“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 said.
Funding from a UniHealth Foundation grant will be used to hire an additional full-time pharmacist to float among the clinics and expand the number of disease, management programs available to patients, said Kathleen Johnson, associate professor of clinical pharmacy and pharmaceutical economics and policy.
“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 said.
He added, “This project is a great opportunity for the USC School of Pharmacy to develop models that can be adopted throughout the country.”