Even before pharmacy school, attending RAM was always on my bucket list of things to do, so I was very eager to participate. At this year’s RAM, a thousand volunteers served over 2,700 patients seeking health care that they needed. It was truly rewarding in that we pharmacy students could play a variety of roles to promote health in underserved communities.
We were involved in medication reconciliation, took vital signs at triage, premedicated before dental procedures, and helped with immunization and counseling at pharmacy pickup. I was particularly impressed to see how RAM expanded the availability of immunization vaccines. Countless number of patients expressed their gratitude in receiving vaccines because they can be costly or simply because they are not aware of their immunization status or risk.
I encountered most patient interaction at the A1C triage and the premedicating session. I learned how to effectively communicate with patients about their A1C or blood pressure results. Instead of just telling them the numbers and their goals, asking questions like “What do you think this number means?” or “What do you think your sugar control is at?” triggered the patients’ reflection on how much they are taking care of their health, which increased their involvement in our conversations.
Showing patients how much their ASCVD [atherosclerotic cardiovascular disease] risk value can decrease by quitting smoking seemed more powerful of an education tool than providing a smoking cessation.
Especially since patients reside in remote areas with limited access to health care, I firmly believe they need to be reinforced to change their health lifestyles. Whenever I encouraged patients to consume more vegetables on daily meal, they complained they couldn’t afford healthy ingredients because of the high cost. Seeing patients eating McDonald’s while waiting at premedication area or smoking all over the grounds frustrated me as we struggle to improve their health.
COPD exacerbation will continue if a patient does not quit smoking. Hypertension will remain if a patient continues eating high-sodium food. Engaging with these patients showed me that lifestyle modification should serve as the initial treatment even before giving blood pressure medication. Pharmacists can intervene to prevent common risk factors, such as inappropriate diet, physical inactivity and smoking.
With our motivational interviewing skill and disease state background knowledge, we can deliver impactful conversation to patients to avoid these risks in the first place, then we can prevent the deadly diseases.