When Lynda Thomson, Pharm.D., CACP, moved to a newly created position with the Jefferson Antithrombotic Therapy Service in the Division of Internal Medicine in 2001, she decided to apply to the ASHP Foundation’s 2001 Anticoagulation Management Traineeship. “I had been practicing as a pharmacist specializing in the area of Infectious Diseases for many years,” she says. “I really wanted to get more training in this new area so that I would feel more comfortable managing my patients.”
Thomson became a trainee under the tutelage of Stuart Haines, Pharm.D., at the University of Maryland. For several days, she visited different anticoagulation clinics in Maryland, learning about the systems they had in place and taking note of what she could implement at Jefferson. “This was the first time that the Jefferson Department of Medicine had hired a full-time pharmacist in this role, so although there was already an anticoagulation program in place, I was able to focus efforts on the expansion of an inpatient to outpatient venous thromboembolic disease (VTED) treatment program, which facilitates early discharge from the hospital, and assisted with the expansion of similar programs to our entire health system,” says Thomson. “Our staff within the Jefferson Antithrombotic Therapy Service traveled to our various hospitals to develop similar systems at their institutions, which has significantly decreased the length of stay for treatment of VTED.”
Thomson’s team within the Jefferson Center for Vascular Diseases pays particular attention to the personalized, special care they offer to their patients. They offer their services 24 hours a day, 7 days a week, and spend a lot of time with patients monitoring and adjusting dosages of their antithrombotic medications, monitoring for adverse effects and working with their insurance companies to assure patients are able to obtain an adequate and timely supply of their needed medications. Emphasis is placed upon adequately educating patients about their medications, proper administration techniques, potential adverse effects, drug interactions and dietary precautions. The staff within the Jefferson Center for Vascular Diseases, which includes two pharmacists and a nurse practitioner, even follows up with patients on weekends, particularly if patients have been recently discharged from the hospital and are receiving bridge therapy, from low molecular weight heparin therapy to oral anticoagulation. “The patients really like the security of knowing that someone is monitoring them and is available for questions or problems throughout the weekend,” she notes.
The result has been a growing base of very appreciative patients, and recognition from the health system through its STAR (Sensitivity, Teamwork, Awareness and Respect) Program. “We get letters all the time from former patients acknowledging the good care they’ve received,” she says. “Many will tell us, ‘No one’s ever taken care of me like this before.’ Some patients keep our phone number and will call us years later if they have a medication question, just because they know we’ll help them.”
Thomson’s latest endeavor in antithrombotic management is as a member of the development committee to update the curriculum of the ASHP Foundation’s Anticoagulation Management Traineeship. Thanks to the efforts of Thomson and many others, the ASHP Foundation introduced the new Antithrombotic Pharmacotherapy Traineeship in May 2006.
“This new traineeship is exciting because it will offer a broader range of experiences with all antithrombotic medications,” she states. “There are a lot of new medications coming out with the potential to replace warfarin, and pharmacists need to be prepared to manage patients with these new agents, which in the future may be used more often than warfarin.”