INDIANAPOLIS—Veronica Vernon has, essentially, two jobs.
The Butler University Assistant Professor of Pharmacy Practice spends about half her time teaching student pharmacists and student physician assistants in the College of Pharmacy and Health Sciences, and the rest of her time is spent at the Richard L. Roudebush VA Medical Center in Indianapolis. At the VA, where she has worked since 2011, she sees Iraq veterans, Afghanistan veterans, male veterans, and transgender veterans. But there was one segment of the population she noticed she was seeing more and more of: female veterans.
The total veteran population is projected to decline from 20.0 million in 2015 to 11.9 million in 2045, according to the Department of Veterans Affairs. And male veterans are expected to diminish by nearly half over that same time period. But despite all of this, the number of female veterans has been on the rise, and is projected to continue going in that direction.
However, Vernon says, services have not necessarily matched that trend.
“For the foreseeable future, there will be more and more female veterans coming through the VA and we need to adapt and learn how to provide the best possible care for them, just as we have done for men,” Vernon says. “A team-based approach to care of female veterans is required. The VA desires to be a leader in women’s healthcare.”
So Vernon, who specializes in women’s health, took matters into her own hands. She, along with Butler graduates Maggie Meuleman and Christina White, and Butler undergraduate Sarah Lenahan, assessed menopausal symptom management by a clinical pharmacist at the Indianapolis VA.
Their research, which they just presented at the annual North American Menopause Society Conference, showed that female veterans who received care for menopausal symptoms by a clinical pharmacist specializing in women’s health, saw a significant decrease in symptoms.
“We saw major resolution for these patients at the end of this specialized care,” Vernon says. “That highlights two important things. One, pharmacists bring a real value to the healthcare team when it comes to managing disease states. And two, which is probably even more important, is that most VA’s don’t have a pharmacist who focuses on women’s health issues. Women’s healthcare is a rapidly growing area in the vet population and the more we focus on it, evidently, the better off patients will be. This population deserves the best possible care and we need to start giving that.”
From August 2013 to August 2017, Vernon and her team tracked a total of 121 patients at the Richard L. Roudebush VA Medical Center in Indianapolis. The average age of the female veteran patients was 52.
When Vernon and her team started seeing patients, the average number of hot flashes or night sweats reported was 11.9 per day. After a year of being treated by the team of pharmacists dedicated to women’s health, the average number of hot flashes or night sweats reported was 1.4.
The percentage of patients reporting vaginal dryness, irritation, and pain during intercourse prior to pharmacist management was 57 percent. After a year of pharmacist management, the average was 6.6 percent.
In all, 88.4 percent of patients who had vaginal dryness, irritation, and pain during intercourse, saw resolution, Vernon says. The team followed up with patients, on average, every three weeks, and used different therapies depending on the situation. Some therapies were hormonal agents, non-pharmacological, Gabapentin, and Clonidine.
“Physicians have limited time to fully dive into the different obstacles patients are facing and then counsel the patient all the time. We believe this research shows the power of having a pharmacist as part of the care team,” Lenahan says. “After the initial diagnosis is made by the primary care physician, the pharmacist can enter the picture and manage the disease state from there in a much more specialized, specific way.”
And nowhere is the power of this continuity of care clearer that at the VA, Vernon says, where female veterans are on the rise, yet there is a real gap when it comes to adequate services. Many providers at the VA have never had a female patient so there is a discomfort and lack of knowledge when it comes to treating things, such as menopausal symptoms, she says.
But as this segment continues to grow, the reality is that providers at the VA will have to treat a female veteran. Having a system in place that utilizes the pharmacist fully, Vernon says, clearly produces results that will benefit patients.
“Our research shows the power of the right care,” she says. “Most VA’s don’t have a pharmacist that focuses on women’s health but the hope is that this data shows how impactful it is, and as this population grows, awareness too grows, in hopes our female veterans get the best possible care. This is about improving access for female vets.”
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