For many patients with moderate to severe digestive diseases, the pathway to symptom relief and lasting remission requires finding a specific medical therapy to meet the individual needs of a patient and their disease. Many barriers interfere with the patients’ access to the very drugs that can lead to symptom improvement and healing. Likewise, more advanced medical therapies require expertise in the complexity of drug interactions with other medications and effects on different parts of the body.

Fortunately for patients at the University of Chicago Medicine Digestive Diseases Center, specialty pharmacists David Choi, PharmD, BCACP, and Archariya Puangampai, PharmD, BCPS, have honed expertise in helping patients understand their medications, and also navigate other barriers such as insurance challenges to gain access to these life-changing medicines.

Patients often have questions when starting newer medications, even those with strong evidence that these medications are effective and safe. After receiving education about their new prescriptions from gastroenterologists, advanced practice providers, and nurses, patients at the University of Chicago Medicine Digestive Diseases Center also consult with the specialty pharmacist, who explains the benefits and potential side effects of their new medication—and answers their many questions.

“The questions that patients ask about these medications are fundamental, and important,” explains Dr. Puangampai, “How does it work? When will I start to feel better? And what side effects should I expect?”

“And, ‘How do you know it’s safe?’” adds Dr. Choi. “We reassure patients by explaining exactly how rare specific, frightening side effects can be, and teach them what they should do if they develop more common, less severe side effects.”

Many patients experience challenges when maintaining a medication regimen over time, and pharmacists also reinforce the importance of following through with the dosing schedule and other instructions that come with their prescriptions.

“When we do the initial education sessions with our patients, we focus on what happens when patients miss a dose—for some of our medications, if patients miss a single dose, we must completely re-titrate the medication [adjust the quantity of a medication in a solution]. After their initial consultation, we follow up with the patients with phone calls to check in about a week after their visit,” explains Dr. Choi.

The University of Chicago Medicine Digestive Diseases Center also provides detailed descriptions of each medication directly to each patient, via MyChart, that describes dosing information, risks, benefits, and side effects, to make sure multiple communication channels remain clear and open for the patient.

Patients also sometimes need assistance navigating insurance coverage of medications. Insurance companies provide payment for medications and doses, and occasionally, those companies will deny coverage for a patient’s recommended therapy. This process can delay treatment, and frustrates both patients and clinicians. When this happens, physicians’ office staff and pharmacists appeal these decisions, providing justifications about an individual patient’s need for the chosen medical therapy. Dr. Choi and Dr. Puangampai provide the necessary documentation to help these approvals go smoothly. Explains Dr. Choi, “Different patients have different needs. We document the physician’s therapeutic choice, and if a patient has a fear of needles, or needs to travel regularly, we specify that in our communication with insurance companies to help access medications that might otherwise not be approved.

The goal of the multidisciplinary team of the University of Chicago Medicine Digestive Diseases Center is to get patients the care they need, and the specialty pharmacy plays an important role in that process. Says Dr. Choi, “From gastroenterologists, to advance practice providers, to pharmacy, we are always going to be assessing therapeutic plans to make sure that we treat you safely and effectively.”