A top priority for Licking Memorial Health Systems (LMHS) is patient safety, including taking action to avoid preventable injuries or deaths caused by improper medication management.  In 2003, LMHS established the Licking Memorial Medication Therapy Clinic to educate patients on proper disease management and the use of certain anticoagulation medications, or blood thinners.  The staff focuses on teaching correct dosing and the importance of monitoring the blood clotting rate. The Clinic since has expanded to assist patients with anemia due to chronic kidney disease and those with diabetes.

While anticoagulants protect against heart attack and stroke, the use of these medications does include risks, such as increased bleeding if cut or injured.  Blood thinners work to prevent blood clots from forming or becoming larger, which keeps blood smoothly flowing through veins and arteries.  Anticoagulants are used to treat some types of heart disease and heart defects, and other conditions that could raise the risk of dangerous clots.  When the Clinic first began, most patients were prescribed Coumadin^® and required a prothrombin time (PT) and International Normalized Ratio (INR) blood test to help determine the blood clotting rate and whether the dosage should change.  The vital testing must be accomplished at recommended intervals in order to keep the PT/INR result in the safest range for the medical condition.  Now, staff members also assist patients with newer anticoagulants such as Xarelto^® and Eliquis.^®  The goal is to provide education regarding safe, accurate medication dosing and close monitoring to reduce adverse events and hospitalizations.

Patients with diabetes also visit the Clinic to learn to manage the disease and for assistance using insulin and monitoring blood sugar levels.  Staff members educate patients on how to perform finger stick tests, proper injection techniques and insulin dosing.  In addition, the staff offers information and support to make necessary lifestyle changes including diet and exercise.  Patients are offered dietary services and referred to Licking Memorial Wellness Centers to assist with increasing physical activity.
The Clinic staff includes pharmacists, point of care technicians and nurses.  Patients receive personalized care and spend time with the staff discussing their daily routines and lifestyle.  Newly referred patients can expect to visit the clinic at least every two weeks or more as needed to monitor blood levels and establish management practices for the medications prescribed. 

The pharmacists also spend quality one-on-one time with patients to make any needed medication adjustments and offer guidance through any health issues they may be experiencing.  While pharmacists do not make diagnoses, they are specially trained in disease management.  The Clinic offers a unique, controlled environment where the pharmacists can use their years of experience to focus on the needs of the patient, and the patient can ask questions about their medications and other concerns.  These interactions are valuable in assisting the patient maintain good health and avoid visits to the Emergency Department.

The staff at the Medication Therapy Clinic enjoy a very close relationship with LMHS physicians and Licking Memorial Health Professionals practices, including Surgical Services, Vascular Surgery, Hematology and Endocrinology.  The team at the Clinic often coordinate care for a patient by ensuring that all providers are aware of the set standard guidelines for the patient once a treatment plan has been established.  A patient on blood thinners requires specific considerations for certain procedures, including annual preventative measures such as a colonoscopy.  With the assistance of the Clinic staff, everyone involved in the procedure is aware of the patient’s needs and adheres to the set guidelines.

Recently, State Senator Jay Hottinger visited the Medication Therapy Clinic to discuss actions the Ohio legislature can take to help improve patient care.  He discussed a number of topics including issuance of Medicaid Provider Numbers to pharmacists, expansion of the supplies and medications a pharmacist can dispense without a prescription under a physician protocol, and allowing pharmacists to enter into consult agreements collaborating care with nurse practitioners and physician assistants while maintaining proper physician oversight.  LMHS leadership detailed to Senator Hottinger how these changes would increase patient access to needed services, allow pharmacists to deliver additional enhanced services, and improve patient outcomes by providing better coordination of care.  The Clinic also received accolades from Sen. Hottinger for participating in a pilot program with OSU to train new pharmacy students.