July 26, 2021

The Role of the Clinical Pharmacist in an IBD Medical Home

How an IBD specialist pharmacist enhances patient care

The Featured Image for the post

The inflammatory bowel disease (IBD) patient-centered medical home offers patients an integrated experience that avoids the fragmentation of care often associated with the complex nature of the disease and its multiple comorbidities. Cleveland Clinic’s IBD medical home recently added a clinical pharmacist who specializes in IBD to its team of gastroenterologists, surgeons, nutritionists, dietitians, nurses, nurse practitioners and psychologists, who work together to capture the needs of the patient beyond the biological disease itself.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Patient-centered medical homes aim to overcome some of the problems associated with the fragmentation of care by providing integrated care, improving patient experience and reducing costs. Although medical homes have already demonstrated advantages when applied in a primary care setting, recent incentives have aimed to apply this model of care in patients with IBD and other chronic gastrointestinal conditions.

“The ultimate goal of an IBD medical home is to optimize patient outcomes. Given complex treatment regimens that often come with insurance barriers and adverse effects, clinical pharmacists can play a significant role in overseeing and managing medications to help patients feel better, experience an improved quality of life and attain remission,” says Shubha Bhat, PharmD, who is currently the clinical pharmacy specialist in IBD.

IBD medical home and pharmacology

The biologics and small molecule inhibitors often used in IBD treatment require close patient monitoring, extensive interaction with insurance companies, and time-intensive patient education. According to Dr. Bhat, the nature of these treatments opens the door for pharmacists to play a significant role in patient care.

Advertisement

“The pharmacist in this setting has four primary roles: medication education, medication monitoring, health maintenance assessments and financial toxicity management,” says Dr. Bhat. “In this outpatient setting, we form collaborative agreements with the partnering physician to provide these services for patients. Physicians can spend their time on diagnosis and treatment, while we provide patients with an in-depth education on the treatment itself in terms of what they need to do, what they can expect and the financial impact.” Dr. Bhat is available to meet with patients who struggle with medication adherence or adverse effects, insurance barriers, and health maintenance issues like smoking cessation and need for immunizations. She also follows patients longitudinally to provide medication monitoring and can identify patients who may warrant a change in or optimization of medications.

“Having an IBD pharmacist available to educate patients on how the treatments work, to emphasize the importance of adherence and commitment and to make them aware of financial resources allows us to provide the comprehensive care that is the hallmark of the medical home model,” says Miguel Regueiro, MD, Chairman of Cleveland Clinic’s Digestive Disease & Surgery Institute. “As a physician I consider it an invaluable resource for my patients.”

Beyond patient care

In addition to playing a crucial role in the treatment process for patients with IBD, Dr. Bhat precepts pharmacy students and residents and works with gastroenterology fellows who are learning the intricacies of IBD treatment. She also conducts research related to medications and the medication-use process, including biosimilars implementation and adoption. Additionally, her research has also focused on highlighting the role and impact of clinical pharmacists on IBD care, with hopes that other IBD practices and centers will integrate pharmacists in the multidisciplinary team setting. Dr. Bhat is also passionate about advocating for insurance reform to improve medication access for patients. “We need to transform the current landscape that requires hours upon hours of provider time gaining prior authorization for medications,” says Dr. Bhat. “Part of my research is focused on rethinking that approach entirely, as it’s a barrier to optimal patient outcomes.”

Advertisement

Related Articles

Doctor talking with patient
February 21, 2024
Consider Risk Factors When Deciding Care Path for Postoperative Crohn’s Disease

Strong patient communication can help clinicians choose the best treatment option

Liver disease
August 17, 2023
Diagnosis and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome

Brief pearls for diagnosis and management of ascites and relevant conditions associated with decompensated cirrhosis

22-DDI-3283958 CQD Neuro GI program preview-Gabbard
January 6, 2023
New Neurogastroenterology and Motility Center Provides Coordinated Care

Hard-to-treat GI disorders benefit from multidisciplinary approach

20-DDI-1971367-CQD-Tunneled-Intravenous-Catheters
October 27, 2020
Risk of Deep Vein Thrombosis in Patients with IBD: Choosing a Catheter for Parenteral Nutrition

Rate is lower with tunneled intravenous catheters

20-DDI-1887417-Rizk_whatIsACO-FAQs-CQD-650×450
July 24, 2020
Enhancing Quality and Value of Care through Accountable Care Organization Relationships

Cleveland Clinic’s ACO takes a team of teams approach

20-DDI-065 Complex hernia repair hero 650×450
April 7, 2020
Case Report: Complex Hernia Repair Involving Pelvic and Bladder Reconstruction

A multispecialty team was essential for this challenging case

19-DDI-244-Driving-Sedated-CQD
January 20, 2020
Driving After Endoscopic Procedural Sedation: Is a 24-hour Ban Too Long?

Cleveland Clinic study assesses psychomotor recovery

20-DDI-011 Hemorrhoids 650×450
January 9, 2020
Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

Physicians and patients should discuss risks, benefits, expectations

Ad