Adirondack Health’s Ambulatory Pharmacists Alissa Harse, left, and Elisabeth Cottom are pictured outside Adirondack Medical Center. (Provided photo)

SARANAC LAKE — Adirondack Health’s ambulatory pharmacy program provides personalized medication management, ensuring proper medication use and minimizing the risk of adverse effects.

By working closely with healthcare providers, pharmacists Elisabeth Cottom and Alissa Harse help improve patient outcomes, promote medication adherence and optimize treatment plans.

Patients can get help with medication counseling — ensuring they understand how and when to take their medications — and receive help identifying and preventing potential side effects. Ambulatory pharmacists also monitor medications to identify and prevent drug interactions, recommend alternative treatments when necessary, assist with medication refills, and work with the patient’s healthcare team to adjust dosages or medications for better outcomes. Additionally, they can provide guidance on managing chronic conditions, such as diabetes or hypertension, through effective medication use.

Cottom said it’s important to educate patients about which medications they are taking and why they are taking them.

“This will give them more confidence to take the medications,” she said. “This is our most important job.”

As a Doctor of Pharmacy and certified anticoagulation care provider, Harse said successful implementation of a Collaborative Drug Therapy Management (CDTM) program also helps reduce overall healthcare costs.

“Our patients are truly appreciative of the time we spend explaining how the medications work, ways to implement lifestyle strategies to complement the medication therapy, and our ability to give them better general understandings of their health conditions and why certain drugs are prescribed.”

Establishing relationships with their patients helps Harse and Cottom build trust, which increases communication between patients and their healthcare providers. Harse said these interactions lead to more than just medication counseling.

Patients may not want to add a given medication to their regimen for several reasons, including cost, fear of side effects, misinformation about adverse effects, medication burden and complexity, and overall lack of access to medication(s). Lacking access to proper medication is a major barrier to a patient’s health, and with healthcare and out-of-pocket costs being substantial for some patients, Harse and Cottom can help many of them through different strategies.

“We can help with discounted co-pay cards, patient assistance programs, or therapeutic substitutions, so they don’t go without their prescribed medications,” Harse said. “There is also a huge deficit of pharmacies in our area, with three closing in the Tri-Lakes region alone in the last six years. Because of this, we have become a main point of contact for our patients in terms of questions and concerns, as the local retail pharmacists’ workloads continue to increase.”

Drug shortages also have large impacts on patients, and Harse and Cottom can assist both patients and providers in finding alternatives or solutions to these issues.

Finally, they are able to help patients and their providers navigate insurance prior authorizations and formulary issues, to gain access to prescribed medications.

“We have the time to explain to patients exactly what they can expect when taking a medication, how it will benefit them, and some of the risks involved,” Cottom said. “In this healthcare environment, it is important for patients to also advocate for themselves, but without knowledge, this is difficult.”

Cottom is a Doctor of Pharmacy, certified diabetes care and education specialist, and board certified as an ambulatory care pharmacist. She is also board certified in advanced diabetes management (BC-ADM), which is a special designation obtained through passage of a rigorous national exam and demonstrable expertise in diabetes management.

“This means that I can start and manage insulin pumps and therefore manage people’s diabetes at a higher level,” she said.

While there are many patients that Cottom and Harse have helped over the years through ambulatory pharmacy, Cottom said one who really stood out to her was referred through diabetes medical management. The patient’s HbA1c was above 10% for years. Hoping to improve their diabetes through dietary changes, they did not want to add any more medications.

“I always explain the benefits of taking medications in a way the patient understands,” Cottom said. “I also make sure they understand the risks. After a few appointments to discuss a treatment plan with which this patient would be comfortable, they started their new medications. Over the next year, their HbA1c came down to 7.2%. We continued to refine their meds further and now their HbA1c has been below 6.5% for months. They are proud of what they accomplished, and I am happy to have helped them get below their goal HbA1c after years of uncontrolled diabetes.”

Cottom and Harse are available to assist healthcare providers with drug requests, medication consults, and the selection of medications that best fit the patient’s diagnosis. They also help providers and nurses by explaining complex medication issues to patients and completing intricate prior authorizations.

“Being able to help patients with their medications from an ambulatory care perspective is so rewarding,” Harse said. “I’ve had the opportunity to work in many facets in the pharmacy world, including inpatient hospital pharmacy, administration, and retail pharmacy, and I find that direct patient care in the outpatient setting seems to have the largest impact. Collaborating with other healthcare providers in this realm produces a team-based approach in which all of us do our part to improve the lives our of patients.”