After we were done at the hospital, Kathryn and I volunteered at Good Shepherd's Free Clinic. It is a small clinic located at the old YMCA in Salisbury. It is only open on Thursdays and runs solely on donations from the community. Ted, the primary care clinical pharmacist volunteers here every Thursday, so we decided to join him! The clinic has a surprisingly large pharmacy, fully stocked on almost any medication you can think of (except for controlled substances). While waiting for the pharmacy to open, I helped the nurses perform vitals on their patients including checking a patient's blood glucose level. We then stayed primarily in the pharmacy to fill prescriptions that came our way. Lori (a pharmacy student at UNC) also came with her preceptor, Steve (of Innes St Pharmacy). Ted was constantly quizzing us on drug facts, so that kept us on our toes while working. Overall it was a great experience!
Courtney (PharmD from Wingate) is the current infectious disease (ID) clinical pharmacist in the clinic. She actually is one of two clinical pharmacists in Home Based Primary care. In October, the current ID pharmacist left, so Courtney has been filling in since then. Good news though, a new ID pharmacist will be coming in within the next month. Everyone is very excited for that!
The day started with a meeting with us, the ID physicians and nurses. Here, they discussed patients who are eligible to receive Hepatitis C (HCV) treatment. Previously, the common treatment for a HCV patient would be peginterferon alfa-2a, an anti-viral (simeprevir, boceprevir) and ribavirin. A new medication, Sofosbuvir, came into the market in December of 2013. This drug has a very high cure rate, and is very expensive (Upwards of $80,000 for a three month treatment, in addition to the cost off the other medications). Keep in mind that the VA essentially pays for everything. Because of this, it is important to properly screen and evaluate patients who are eligible and ready to begin this treatment. They went through patient cases, evaluating factors such as if it was their first treatment, if not, then if they relapsed/reached futility, and from what treatment regimen, NS3 test results (for mutations), what genotype of Hepatitis C they are, if they have co-morbidities (other disease states), and presence of mutations.
The rest of the day consisted of us meeting with patients regarding
their current treatment regimen. We also got to tell a patient he is cured of Hepatitis C!