VA Pharmacy Services in the Lowcountry of SC, Georgia

Last week’s military and veterans’ benefits section of The Island News talked about the ultra-modern, safe, and highly dependable VA Consolidated Mail Outpatient Pharmacy (CMOP) system and the award-wining Ralph H. Johnson VA Health Care System Pharmacy and its’ services. That first article of a series of two covered “a to z” on how the process of ordering and reordering, documenting patients’ records, filling, shipping, and delivery of prescriptions works for veterans.

This column will provide more information on:

1. The medical reconciliation process used by VA physicians and pharmacists to ensure there is a complete and up-to-date list of all of the medications that the Veteran is taking.
2. The important role the Ralph H. Johnson VA Health Care System (RHJVAHCS) Clinical Pharmacy Practitioner plays in providing comprehensive medication management to our Veterans.
3. The role the VA Clinical Pharmacy Practitioner plays in providing comprehensive medication management to veterans.
4. A reminder for veterans to bring a list of all medications to each medical appointment and more helpful information.

Medication Reconciliation

Medication reconciliation is the process used by physicians and pharmacists to ensure there is a complete and up-to-date list of all of the medications that the veteran is taking in the veterans’ medical records and with the veteran. This process is extremely important to avoid medication errors, adverse reactions, and drug interactions. Veterans should bring a list of all medications that includes the dosage (strength) and frequency taken to every appointment.

This list of medications should include medications prescribed by the VA, community providers (doctors, nurse practitioners, physician assistants), and over the counter medications and any herbal/non-traditional medications.

The Role of the VA Clinical Pharmacy Practitioner

Veterans are fortunate that the VA utilizes a clinical pharmacy practitioner to optimize medication use, which assists primary care providers and specialists in providing quality outcomes for a variety of chronic (persistent) conditions facing the veteran population. Comprehensive medication management, delivered by a pharmacist, working in collaboration with the patient focuses on an individualized plan to assist in meeting the goals of medication therapy.

The Ralph H Johnson VA Health Care System has clinical pharmacy practitioners in primary care and a wide variety of specialty areas. The main facility (medical center) in Charleston and each Community Based Outpatient Clinic (CBOC) has pharmacists supporting each Patient Aligned Care Team (PACT). These pharmacists assist patients in the management of medications for Diabetes, high blood pressure, heart failure, and a variety of other chronic diseases. There are also VA clinical pharmacy practitioners that work in the following specialty areas:

1. Pain management, Neurology (Nervous system), Endocrinology (endocrine glands and hormones), Transplant, and Rheumatology (infectious disease of joints and other parts of the musculoskeletal system) and
2. Anticoagulation (blood thinners), Anemia management (low amount of healthy red blood cells) hemoglobin, Oncology (tumors and cancer), and Infectious Disease (HIV, COVID, etc.).

Doctors and patients need pharmacists

Most physicians and providers have the training and experience to manage medications effectively within their area of general or specialist knowledge. However, they can and do consult with VA pharmacists to resolve drug therapy problems. Physicians, nurse practitioners, and physician assistants also use pharmacists to coordinate the ever-increasing use of herbals and supplements that interfere or enhance a drug’s effect in complex patients. Physicians and providers team with pharmacists in performing comprehensive medication reviews.

Adverse reactions and interactions are seen frequently with multiple medications and are compounded by the effects of chronic disease on organ systems. For example, the veteran’s primary care provider may seek a comprehensive medication review from a clinical pharmacist to determine medication interactions or they may ask the clinical pharmacist to assist in managing a Veterans diabetes medication to help the patient meet their goals.

The VA’s Physician, providers, and pharmacist team approach to medical services focuses on chronic disease management, as well as preventive therapies. This team effort has resulted in many improved outcomes for veterans.

Ralph H. Johnson VA Health Care System Pharmacy employees are an award-winning team

It is reassuring that the Ralph H. Johnson VA Health Care System (RHJVAHCS) Pharmacy Team and services are one of the dozens of reasons that our local VA Medical Center and System is a five-star operation and has been rated in the top ten percent of all public and private hospitals in the USA for quality of care and dozens of other performance measurements. Below are a few of the reasons our local VA Medical System and Pharmacy make up a world class medical system.

1. The Ralph H. Johnson VA Pharmacy team is led by Doctor Sharon Castle has been awarded the Lewis Blackman Healthcare Executive Award for leadership in Opioid Safety.
2. Doctor David Taber, RHJVAMC Transplant pharmacist, received the 2020 American Pharmacy of Clinical Pharmacy (ACCP) Clinical Practice Award, a national award recognizing his substantial and outstanding contributions to clinical pharmacy practice. This award recognizes him for his exceptional leadership and development of innovative clinical pharmacy services.
3. Doctor Chad Lavinghousez was recently recognized by the VA Secretary, at a recent site visit, for his work with Covid vaccinations at the RHJVA.
4. Pharmacy Doctors Alison Martin and Julianne Isaac recently published an article in the American College of Clinical Pharmacy that highlights the clinical pharmacy practitioner’s role in ensuring safe monitoring of drug therapy in multiple sclerosis patients. Dr. Martin is one of a very limited number of clinical pharmacy practitioners who specialize in neurology practice providing medication management for headache management, seizure disorders, and a host of other neurology related conditions.
5. The RHJVAHCS Pharmacy Team has been selected by the Coastal SC Chapter of the Association of the US Army (AUSA) to receive their coveted Outstanding Service Award. This award recognizes teams and individuals who provide outstanding services and care to veterans, military members, and their families.
6. Multiple pharmacists at the RHJVAMC and surrounding CBOCs have been recognized as Preceptor (educator) of the Year to pharmacy students over the years. The excellent pharmacy staff at the RHJVAHCS is continuously training new pharmacists and students. The pharmacy staff at RHJVAHCS take very seriously their role in developing their profession and new pharmacists to serve veterans for years to come.

Some things to remember

1. Read and follow the instructions provided online. Veterans and their family members should read about the Charleston health care pharmacy services at https://bit.ly/3M8M2bt. Veterans can find out at this website how to refill their prescriptions, where to pick up new prescription orders, and how to safely dispose of their medicines at the VA Charleston health care facility and the CBOCs.
2. RHJVAMC pharmacy hours. Veterans can contact at the RHJVAHCS Pharmacy Department at 843-577-5011, ext. 15220. Hours of operation are Monday through Friday, 7:30 a.m. to 7 p.m., and Saturday and Sunday, 8 a.m. to 4:30 p.m.
3. Order refills 10 days before you run out. Veterans VA health care benefits include prescription medicines and medical supplies prescribed by your VA health care team. Veterans should order refills at least 10 days before your supply runs out. With the VA’s Prescription Refill and Tracking Tool, veterans can refill their VA prescriptions, track their delivery, and create lists to organize your medicines.
4. Order refills online or by phone. Veterans can refill prescriptions online. Veterans can sign in with their existing ID.me, DS Logon, or My HealtheVet account. If a veteran does not have any of these accounts, they can create a free ID.me account at the https://bit.ly/3IAr438 website. Veterans served by the RHJVAHCS can phone in refills by calling 843-577-5011, ext. 15220 or 888-878-6884, select 1, which is toll free from outside the Charleston area.
5. Mail order refills. Veterans need to mail back the refill request form that comes with their prescription to the provided address. For Veterans unable to complete refills through My HealtheVet or by phone, the refill request form that comes with the prescription can be mailed back to the provided address.
6. Picking up new prescriptions. Veterans can pick up new prescription orders at one of the VA Charleston health care pharmacies.
7. Refills should be requested online, by phone, or mail. The VA requests that veterans please not try to refill prescriptions in person, so their pharmacists can focus on providing care to Veterans with urgent needs and new prescriptions. Refills are only available online, by phone, or mail.
8. Follow your doctor’s and pharmacist’s instructions. Do not become another tragic statistic. According to Centers for Disease Control and Prevention’s (CDC’s) November 17, 2021 announcement, “Provisional data from CDC’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5 percent from the 78,056 deaths during the same period the year before. To read the CDC announcement, go to: https://bit.ly/3IVvxNP.
9. Safely dispose of old and no longer needed medication. Veterans can drop off expired or unwanted medicine at a MedSafe box. Disposing of your medicines safely can help protect other people as well as the environment. You can find the large blue MedSafe boxes at all VA Community Based Outpatient Clinics (CBOCS) and at the Ralph H. Johnson VA Medical Center’s Outpatient Pharmacy, on the First floor. The Drug Enforcement Agency (DEA) Website at https://bit.ly/340r9hh can also help you locate an on-site receptacle in your community.
10. List of medications. Bring a list of all medications to each medical appointment. Keep an up-to-date list of your medications on your cell phone. You may want to take a picture of the label on each of your prescription medications and across the counter drugs and supplements.

The Island News and Larry Dandridge wish to thank the RHJVAHCS Chief of Pharmacy Services, Doctor Sharon Castle and the Public Affairs Officer (PAO) Wayne Capps for allowing this writer to interview Dr. Castle and for providing much of the information in these two articles on VA Pharmacy services.

Larry Dandridge is a Vietnam War wounded warrior, disabled veteran, ex-Enlisted Infantryman, ex-Warrant Officer Pilot, and retired Lt. Colonel. He is a past Veterans Service Officer, a Patient Adviser at the RHJ VA Hospital, the Fisher House Charleston Good Will Ambassador, and the VP for Veteran Affairs for the local Army Association Chapter. Larry is the author of the award-winning book Blades of Thunder and a contributing free-lance writer with the Island News. Contact him at LDandridge@earthlink.net or 843-276-7164.