FUNCTIONAL MEDICINE IN PHARMACY PRACTICE Suzanne Keyes, PharmD, - - PDF document

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FUNCTIONAL MEDICINE IN PHARMACY PRACTICE

Suzanne Keyes, PharmD, FACA, IFMCP Keyes’ Compounding & 180 Wellness Elk City, OK

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DISCLOSURES

it’s about transparency

I, Suzanne Keyes, declare no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

LEARNING OBJECTIVES

Identify target patient populations and outline marketing strategies and themes for expansion into functional medicine. Discuss the functional medicine market and the health care professions involved who are potential partners for pharmacy. Discuss an appointment- based model for functional medicine, pharmacy workflow & add-on revenue opportunities.

it’s about education

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• Independent community pharmacy represent 36% of U.S. retail pharmacies and

are capturing $80 billion dollars in the current marketplace

BUT

• Below-cost reimbursements, exacerbated by DIR fees in Medicare Part D,

contribute to gross margins falling by 5% over the past five years

AND

• 52% of total prescriptions are covered by the Medicare Part D and Medicaid
• programs. (10,000 people a day are turning 65 years old)

DID YOU KNOW?

it’s about the facts

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TOP 5 MEDICINES IN THE U.S.

based on number of monthly prescriptions written in millions

SYNTHROID CRESTOR VENTOLIN NEXIUM ADVAIR

18.2 18.2 13.7 13.7 21.4 21.4 15.2 15.2 21.5 21.5

https://www.webmd.com/drug-medication/news/20150508/most-prescribed-top-selling-drugs

THE PHARMACIST’S ROLE NOW

it’s about change

• The Role of the Pharmacist as Part of a Multidisciplinary Cancer Care Team

https://www.specialtypharmacytimes.com/publications/specialty-pharmacy-times/2018/may-2018/the-role-of-the-pharmacist-as-part-of-a-multidisciplinary-cancer-care-team

• The Pharmacist's Role in Educating Patients on Medical Cannabis Use

https://www.pharmacytimes.com/conferences/ashp-summer-2018/the-pharmacists-role-in-educating-patients-on-medical-cannabis-use

• Use of Pharmacogenomics Data within Pharmacy Practice

https://pharmacist.com/2018-apha-policy-topics

• The Pharmacist’s Role in Educating the Health-Care Team About Adverse Effects of Immune

Checkpoint Inhibitors

http://www.ascopost.com/issues/may-25-2018/pharmacist-role-in-educating-the-health-care-team/

• Pharmacists called to take lead 
in pharmacogenomics—the bridge 
to personalized

medicine

https://www.pharmacist.com/article/pharmacists-called-take-lead-pharmacogenomics-bridge-personalized-medicine

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• The results of 11 studies published since 1978 indicate that technicians'

accuracy in performing final dispensing checks is very comparable to pharmacists' accuracy Adams AJ, Martin SJ, Stolpe SF. "Tech-check-tech": a review of the evidence on its safety and benefits. Am J Health Syst

• Pharm. 2011;68(19):1824-1833.
• California, Colorado, Idaho, Iowa, Kansas, Kentucky, Michigan,

Minnesota, Montana, North Dakota, South Carolina, Washington, Maryland, North Carolina, and Oregon

TECH CHECK TECH (TCT)

it’s about trust

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The Standard American Diet 01 Environmental Exposures 02 Chronic Stress 03 Nutrient Depletion 04

RANDOM PIECES

it’s about creating a picture

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CONVENTIONAL MEDICINE LOOKS AT: FUNCTIONAL MEDICINE LOOKS AT:

IRRITABLE BOWEL SYNDROME Biologics; increase fiber; stress reduction Nutrient deficiencies; food sensitivities; inflammation; underlying parasitic/fungal/bacterial infections; hormone imbalances DEPRESSION/ANXIETY Anti-depressants; anxiolytics; counseling NT pathways; inflammation; nutrient deficiencies; hormone imbalances (including sex steroids, insulin and thyroid); gut microbiome MIGRAINE HEADACHES Medications; rest Hormone imbalances; thyroid; food sensitivities; toxic exposure; nutrient deficiencies CHRONIC FATIGUE SYNDROME Stress management; rest; medications for symptoms Mold/fungal exposures; nutrient deficiencies; thyroid; hormone imbalances

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MEDICATION / CLASS OF MEDICATION DEPLETES CAUSING AMOXICILLIN Lactobacillus acidophilus, Bifidobacterium bifidum, biotin, folic acid, inositol, vitamins B1, B2, B3, B6, B12, and K Dybiosis, neurotransmitter imbalance, weight gain, restlessness, ADHD, anxiety, sleep disturbance, fatigue, thyroid dysfunction METHYLPHENIDATE

Magnesium

Depression, Type II diabetes, ADHD, PMS, Asthma, Epilepsy, Sleep disturbances, Migraines, Angina, HTN, Arrhythmias, Osteoporosis ORAL / INHALED CORTICOSTEROIDS Amino acids, A (beta-carotene) B6, B12, C, calcium, chromium, D, DHEA, Folate, magnesium, melatonin, protein, potassium, selenium, zinc Neurotransmitter imbalance, blood sugar dysregulation, restlessness, anxiety, sleep disturbance, fatigue, dysbiosis, thyroid dysfunction SSRIs Melatonin Iodine Irritability; restlessness, sleep disturbance, thyroid imbalances CLONIDINE Melatonin Irritability; restlessness, sleep disturbance

KEYES’ COMPOUNDING& 180 WELLNESS

it’s about differentiation

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• FIELDS PHONE CALLS
• DIRECTS CONSULT & TEST KIT SALES
• UPDATES EDUCATIONAL PAMPHLETS
• DIRECTS NUTRITIONAL SALES
• EDUCATES PATIENTS ON FOOD

PLANS, CBD, DIND

• COUNSELS PATIENTS
• CONDUCTS CONSULTS
• EDUCATES PRACTITIONERS

25% 50% 25%

CLERK TECHNICIAN PHARMACIST

CHANGE PHARMACY HEIRRARCHY

it’s about reinventing yourself

THYROID

Herbals Glandulars Cofactors

GUT HEALTH

Probiotics Betaine/Pepsin Digestive Enzymes

NEURO

Sleep Mood Boosters

ADRENALS

Glandulars Adaptogens Cofactors

SHELF POSITIONING

it’s about creating the need for education

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COUNSELING OR CONSULTING?

it’s about assigning value

THE PARRATA RULE

it’s about discernment

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Jeffrey Bland, MD www.jeffreybland.com Jill Carnahan, MD www.flatironmedicine.com Chris Kresser, Lac www.chriskresser.com Mark Hyman, MD www.drhyman.com Will Cole, DC www.drwillcole.com Westin Childs, DO www.restartmed.com Jolene Brighten, ND www.drbrighten.com Kelly Brogan, MD www.kellybroganmd.com Steven Gundry, MD www.gundrymd.com Ben Lynch, ND www.mthfr.net www.drbenlynch.com

A FEW OF MY MENTORS

it’s about who you know

Know the condition Know the questions to ask Know the studies, statistics & evidence Know the pathway Know the triggers/exposures/food Know the labs/biomarkers Know optimal ranges Know genetic SNPs exist Know the supplements

:

it’s about what you know

WHAT’S INVOLVED?

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KNOW YOUR WORTH

BUT ABOVE ALL ELSE

it’s about what you know it’s about your resources

WHERE DO I FIND OUT MORE?

https://www.ifm.org https://kalishinstitute.com/blog/become-functional-medicine-practitioner/ https://www.functionalmedicineuniversity.com https://www.uws.edu/human-nutrition-functional-medicine/ https://www.functionalmedicinecoaching.org https://www.schoolafm.com https://smhs.gwu.edu/integrative-medicine/ https://www.a4m.com https://www.integrativenutrition.com

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