Apothecary at University Medical Group Practice (UMGP) - Boulder, CO

APPE Experience Types
Ambulatory Care

Address
350 S Broadway Suite 50
Boulder, CO 80305

Phone
303-499-2789 or 1-866-499-2879

Region
Other Boulder, CO

Site Home Page
While not a website specifically for our facility, the pharmacy is the primary pharmacy for the ADAP program as listed on the AIDS Treatment Data Network website for Colorado: http://www.atdn.org/access/states/co/co.html

Main Contact
Jaymison Arnold, Pharm.D.
Clinical Instructor for University of Colorado School of Pharmacy
jaymison.arnold@uchsc.edu
303-499-2879

Teaching Philosophy

Acquiring clinical pharmacy skills that will ultimately serve as the foundation for a successful pharmacy career is the main objective of this rotation.  As the Apothecary’s primary goal is to provide optimal pharmaceutical care to patients, the educational goals of this rotation will be to expand students’ clinical pharmacy knowledge, particularly in the realm of infectious disease.  Teaching and learning will be approached mostly from review of patient specific cases, but general discussions on various infectious disease topics and meetings (ADAP and journal club) will also be learning opportunities.  Students will learn what drug regimens constitute optimal drug therapy for HIV and TB treatment, how to dose TB and HIV medications appropriately based on body weight and both renal and liver function, and what drug-disease and drug-drug interactions are frequently encountered with the pharmacotherapy utilized in these disease states .  While most students will have already acquired effective communication skills from didactic coursework and previous work experience, the importance of effective communication with both health care providers and patients will be stressed and the opportunity to refine these skills and record pertinent drug or patient information from communications will be plentiful on this rotation.  While students will be under the direct or indirect supervision of a pharmacist at all times, students should be able to work independently at times and have a high degree of self motivation.

Detailed Site Information

Institution
The Apothecary pharmacy is a relatively small ambulatory care pharmacy located within the Flatiron Arts Medical building in Boulder, CO.  The Apothecary pharmacy is directly affiliated with the University Medical Group Practice (UMGP), a primary care facility within the same building serving primarily University of Colorado faculty and staff. Both the Apothecary and the UMGP are an extension of the University of Colorado Health Sciences Center in Denver, CO.  In addition to serving patients of the UMGP, the Apothecary also serves patients of Clinica Campesina, the Beacon Center for Infectious Disease at Boulder Community Hospital, and the Colorado State Department of Public Health ADAP (AIDS Drug Assistance Program) and TB programs.  Both Clinica Campesina and ADAP are specifically for patients with little to no income. 

Pharmacy Services
While the Apothecary provides pharmacy services to a number of clinics (UMGP, Clinica Campesina, and the Beacon Center for Infectious Disease), patients of the Colorado State Department of Public Health ADAP and TB programs make up the majority of the Apothecary’s patient base.  The Apothecary is contracted with the State Health Department to provide pharmaceutical services to patients enrolled in these programs (HIV and HIV treatment related medications to ADAP clients and TB medications for treatment of both latent and active TB to TB clients). Given the Apothecary’s involvement with these programs, which when combined serve roughly between 400 & 500 clients per month, infectious disease treatment and management is the Apothecary’s specialty. A total of 3 full-time pharmacists work on site, each of which has considerable knowledge and experience in the area of infectious diseases.

Professionalism and Assessment
Students will be expected to display attitudes and habits that are reflective of the American Pharmacists Associations Code of Ethics for pharmacy students and pharmacists. 

Resources
Students will have regular access to the internet for medical and drug information (micromedex,medlineplus,etc) and to conduct library database searches.  Free parking is available on site. 

Ambulatory Care

Primary Preceptor
Jaymison Arnold, Pharm.D.
Clinical Instructor for University of Colorado School of Pharmacy
jaymison.arnold@uchsc.edu
303-499-2879

Preceptor
Susan Mead, Pharm.D.
Director of Pharmacy Services at Wardenburg Health Center and 
Clinical Instructor for University of Colorado School of Pharmacy.  
Areas of specialty include drug utilization and formulary review, specifically for the ADAP program.

APPE Structure
Students on this rotation will gain a better understanding of a variety of disease states and their treatment and management, but the primary focus of this rotation will be on the pharmacotherapeutics of several infectious diseases.

The pathophysiology of HIV and AIDS, treatment of HIV infection, treatment and prevention of HIV related opportunistic infections (such as Pneumocystis, MAC and CMV), medication management of the complications caused by antiretroviral therapy, HIV and HCV co-infection, and reasons for non-adherence to antiretroviral therapy will be reviewed extensively. 

The pathophysiology of Tuberculosis as well as the treatment of both latent and active TB infections will also be reviewed. 

Students will learn what drug regimens constitute optimal drug therapy for both HIV and TB treatment, and will evaluate patient specific medication orders and drug regimens to determine clinical appropriateness and to expand clinical knowledge in the treatment and management of these two prominent infectious diseases.

Students will spend time communicating with patients and other health professionals both via phone and in person to answer drug related questions and provide drug counseling.

The topics of drug resistance and compliance in relation to both HIV and TB will also be discussed, as the practice site serves the Colorado State Department of Public Health ADAP and TB programs and the importance of resistance prevention and adherence is critical.  While the vast majority of the student’s time will be spent covering HIV and TB, some time will be spent reviewing the pharmacotherapy of several other infectious diseases based on patient specific cases (treatment of Sexually Transmitted Diseases such as Gonorrhea and Chlamydia, and prevention of infectious diseases such as Typhoid and Malaria while traveling abroad).

Student Roles and Responsibilities
On rotation students will evaluate medication orders, gather and organize data to identify drug-related problems and their causes, develop plans to resolve and/or prevent drug-related problems, document pharmaceutical care activity when appropriate, and provide pharmaceutical counseling and information to both patients and other health care professionals.  Students will create and present one PowerPoint presentation on an infectious disease topic of their choice to several health care providers associated with the University Medical Group Practice and/or Beacon Center for Infectious disease while on rotation.  Students will also participate in a weekly journal club among the pharmacists on site to discuss a relevant topic in infectious disease.

Educational Opportunities
Students will have the opportunity to visit the Colorado State Department of Public Health facility in Denver and attend both general and Medical Advisory meetings with ADAP, a state wide HIV drugs assistance program providing HIV and HIV treatment related medications to low income patients.  Medical Advisory committee meetings create an opportunity for students to become familiar with medication formulary management for ADAP and the decision making process for formulary revisions.  In addition to formulary evaluation, students may have an opportunity to participate in formulary modification.

Other Requirements
While Spanish speaking skills are not necessary, they are extremely advantageous as a large portion of the patient base utilizing pharmacy services are Spanish speaking only.