14

THE STRAITS TIMES

DECEMBER 13 2012

Cover Story
ANTI-COAGULATION CLINIC Who it is for: Typically those at risk of strokes and those on the blood-thinning drug warfarin. What it is for: Warfarin is a high-risk drug that requires close monitoring. Taking too much can cause bleeding and too little can make the blood clot and cause a stroke. Pharmacists review the medication dosage to ensure patients are within the target range. They also provide counselling and advice on its interactions with food and other drugs. Cost: $10 to $40, depending on whether the patient is subsidised and if it is a first or repeat visit. Where: The service is available at Alexandra Hospital (AH), Changi General Hospital (CGH), Khoo Teck Puat Hospital (KTPH), National University Hospital (NUH), Singapore General Hospital (SGH) and Tan Tock Seng Hospital (TTSH). Patients have to be referred by a doctor. ASTHMA-ALLERGY CLINIC Who it is for: Asthma patients who use inhalers and those suffering from allergic rhinitis. What it is for: Pharmacists teach patients how to use inhalers properly and counsel them on the different types of medication used for managing asthma. The clinic also sees allergic rhinitis patients who wish to try sublingual immunotherapy, which involves gradually increasing doses of the allergen. Cost: Free. Where: SGH. Patients must see an SGH doctor first. Call 6321-4377 for an appointment. CARDIAC CLINIC Who it is for: Patients who have had a heart attack and those who have heart failure. What it is for: Pharmacists adjust medication to help patients attain optimum blood pressure, heart rate, cholesterol and diabetic control goals. This will help prevent a repeat heart attack and keep their heart condition from worsening. Cost: $10 to $30, depending on subsidy rates and whether it is a first or repeat visit. Where: KTPH. Walk-ins are accepted, but the pharmacist would be able to give advice only on medicine usage and not adjust the dosage. CARDIOVASCULAR RISK FACTOR MANAGEMENT CLINIC Who it is for: Patients with heart problems and risk factors that predispose them to a heart attack. What it is for: These patients have high blood pressure, blood glucose or cholesterol levels. Pharmacists help bring these to healthy ranges by adjusting medicine dosages. They also give tips on how to lead a healthy lifestyle. Cost: From $10 to $40, depending on the duration of the consultation, level of subsidies and materials supplied during the session. Where: TTSH. No walk-ins accepted. SGH doctor first. Call 6321-4377 for an appointment. LIPID CLINIC Who it is for: Patients who have just started medication to alter their levels of lipids fatty substances in the blood, such as cholesterol. What it is for: Pharmacists closely monitor patients lipid levels, order and interpret laboratory results, and adjust the medicine based on lipid therapy guidelines. Patients are also educated about treatment goals, disease complications, the importance of complying with medication, and the impact of diet and lifestyle on the condition. Cost: From $15 a session, depending on the service required, package chosen and whether the patient is subsidised. Where: CGH. No walk-ins accepted. MEDICAL MANAGEMENT SERVICE Who it is for: Patients who are on multiple types of medication and are not taking them correctly. What it is for: Pharmacists identify why patients are not taking their medicine properly and help to resolve these issues. They will see the patients until these issues have improved, or when the patients conditions have stabilised. Cost: Free. Where: SGH. Walk-ins accepted at the pharmacy in specialist outpatient clinics. MEDICATION THERAPY MANAGEMENT (CARDIOLOGY) CLINIC Who it is for: Heart patients with complicated drug regimens and who are taking more than five drugs concurrently. What it is for: Pharmacists do medication reviews and check for drug-related problems. Patients will also be counselled to improve their knowledge of their medication and to ensure their compliance. Cost: Subsidised patients pay $20 for the first visit and $10 for repeat visits. Private patients pay double. Where: NUH. No walk-ins accepted. ONCOLOGY PHARMACY CLINIC Who it is for: Cancer patients. What it is for: Pharmacists review cancer patients chemotherapy prescriptions to ensure they are accurate and complete. They also educate patients and their caregivers about chemotherapy drugs, record adverse reactions and liaise between the oncology clinic and the pharmacy. Cost: From $10 to $40, depending on the duration of the session, whether the patient receives subsidies and the types of materials supplied during the session. Where: TTSH. No walk-ins accepted. PAEDIATRIC EPILEPSY AMBULATORY SERVICE Who it is for: Children suffering from

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A patient consulting NUH pharmacist Lim Li Jein at the hospitals pharmacist-run Anti-coagulation Clinic. epilepsy and their caregivers. What it is for: Pharmacists educate them about epilepsy and help them understand the use of anti-epileptic drugs to improve compliance and treatment outcome through counselling and the use of a seizure diary. They also monitor adverse drug reactions. Cost: From $9 for subsidised patients to about $20 for private patients. Where: KK Womens and Childrens Hospital. Patients are referred by doctors; walk-ins are not accepted. PAIN CLINIC Who it is for: Those suffering from chronic pain conditions. What it is for: Pharmacists try to understand such patients lifestyles and what triggers the pain. The medication regimen is then tailored to suit them. Their concerns about addiction to pain medication and other medicine problems are also addressed. Cost: From $15 onwards a session, depending on the service required, package chosen and whether the patient is subsidised. Where: CGH. No walk-ins accepted. PERCUTANEOUS CORONARY INTERVENTION CLINIC Who it is for: Patients who have just had a stent or balloon inserted after a heart attack. What it is for: Pharmacists help patients understand their heart condition, the risk factors and the importance of complying with medication to prevent a repeat heart attack. They also adjust the amount of drugs to control blood pressure, lipid levels and diabetes, and encourage patients to make beneficial lifestyle changes. Cost: From $10 to $40, depending on the duration of consultation, whether the patient is subsidised and the materials supplied during the session. Where: TTSH. No walk-ins accepted. PERITONEAL DIALYSIS CLINIC Who it is for: Kidney patients. What it is for: Pharmacists carry out basic health examinations, such as checking of blood pressure, and look for signs of fluid overload. They also adjust the amount of medicine to manage complications from end-stage renal disease and check for compliance to medication. Cost: Free. Where: TTSH. No walk-ins accepted. RHEUMATOLOGY MONITORING CLINIC Who it is for: Patients with inflammatory arthritis, which is inflammation of the joints. What it is for: Pharmacists ensure that such patients prescribed with a disease modifying anti-rheumatic drug are monitored regularly to detect any side effects. Cost: Subsidised patients pay $11.40 for a 15-minute consultation; non-subsidised patients pay double. Where: SGH. Patients must see an SGH doctor first. Call 6321-4377 for an appointment. SMOKING CESSATION CLINIC Who it is for: Smokers. What it is for: It is usually run by Health Promotion Board-certified quit smoking consultants, who could be nurses or pharmacists. The patients smoking and medical history are assessed and a personalised quit plan is tailored for them. Medication is used to aid the quitting process if necessary. Patients are also educated on the harmful effects of smoking, the benefits of quitting and how to cope with withdrawal symptoms. Cost: $10 to $40, depending on whether the patient is subsidised and if it is a first or repeat visit. Where: To make an appointment, call AH: 6476-8828, CGH: 6850-3333, NUH: 6772-2002, KTPH: 6555-8828, TTSH: 6357-7000. TRANSPLANT CLINIC Who it is for: Kidney transplant patients. What it is for: Pharmacists counsel patients pre- and post-transplant about their medication, especially those on immunosuppressive agents. They also highlight the importance of adhering to these drugs. Cost: A lump sum of $600, which covers all future clinic reviews by the pharmacist. Where: SGH. Patients must see a doctor at the hospital first. Call 6321-4377 for an appointment.

DIABETIC NEPHROPATHY CLINIC Who it is for: Patients who have hard-to-control blood pressure levels due to underlying kidney conditions or diabetes. What it is for: Diabetes can cause kidney failure. Pharmacists adjust patients medication to help them attain normal blood pressure and good blood glucose levels. Cost: $10 to $30, depending on subsidy rates and whether it is a first or repeat visit. Where: KTPH. Patients must be referred by a doctor. GERIATRICS CLINIC Who it is for: Elderly patients with multiple conditions and multiple types of medication. What it is for: Pharmacists highlight patients drug-related problems, such as adverse effects, poor compliance to medication and drug interactions with traditional Chinese medicine to the doctor. Pharmacists also work closely with nurses to find out why the patient is not taking his medicine. In one case, a patient had difficulty taking his medicine out of a bottle due to decreased dexterity. The nurse helped to customise the bottles by sticking on Velcro to ease the process. Cost: $10 to $40, depending on the level of subsidies and whether it is a first or repeat visit. Where: At KTPH, walk-ins are accepted but the pharmacist would be able to give advice only on medicine usage and not adjust the dosage. At TTSH, no walk-ins accepted. HEART FAILURE CLINIC Who it is for: Heart failure patients. What it is for: Such patients have to take a cocktail of drugs. Some may not be taking these drugs correctly or may be suffering adverse effects such as diarrhoea. Pharmacists educate them so they know what each drug is for and when to take them. Cost: $10 to $40, depending on whether the patient is subsidised
PHOTOS: NATIONAL UNIVERSITY HOSPITAL, ST FILE

and if it is a first or repeat visit. Where: TTSH. No walk-ins accepted. HUMAN IMMUNODEFICIENCY VIRUS (HIV) CLINIC Who it is for: HIV-positive patients just starting on antiretroviral therapy, those who require a change in their drug regimen, or those who need to be reminded of the importance of sticking to the regimen. What it is for: Pharmacists will explain in detail the role of antiretroviral therapy in managing HIV and Aids, and the importance of adhering to treatment and the right dosage. Advice on how to lead a healthy lifestyle is also dispensed. Cost: Free. Where: TTSH. No walk-ins accepted. INFLAMMATORY BOWEL DISEASE CLINIC Who it is for: Patients with inflammatory bowel disease, a chronic inflammation of all or part of the digestive tract. What it is for: Pharmacists counsel them on medication compliance and check for signs of side effects. Cost: Subsidised patients pay $11.40 for a 15-minute session and $28.15 for a 45-minute session. Non-subsidised patients pay about double. Where: SGH. Patients must see an