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From left, Lorraine Findley, Dr. Valyncia Green, pharmacist, Dr. Honey East, associate professor of medicine, and Dr. Daniel Riche, pharmacist.

One visit to the Cardiometabolic Clinic at the University of Mississippi Health Care (UMHC) Pavilion is all it takes for new patients to discover they're not visiting an ordinary doctor's office.

For starters, a pharmacist greets them to review their medication therapy management and conduct a chronic condition assessment. Next, a physician performs a complete physical exam and corroborating assessment. Then, if necessary, a cardiovascular nurse provides lifestyle specialty counseling tailored specifically to each patient's individual needs.

Daniel M. Riche, PharmD, assistant professor of pharmacy practice and medicine for UMHC, said by the time they leave the clinic, most patients have found themselves surrounded by a complement of medical professionals to help them obtain a healthy lifestyle.

"How often do you get to spend a significant amount of time with a physician, a pharmacist and a nurse?" Riche asked. "Patients get care from all sides of a multidisciplinary approach. They leave us saying, 'I felt like my questions were answered, and I know about my disease process.'"

Leaders in the Department of Medicine who have managed a successful diabetes program at the Jackson Medical Mall Thad Cochran Center envisioned the totality of care concept.

Honey E. East, MD, associate professor of medicine, recruited Riche. They presented the protocol for the clinic's development to the Department of Medicine, which gave its full support.

"This clinic represents growth of the Department of Medicine's commitment to the treatment of cardiometabolic syndrome," said East, a board-certified lipid specialist. "Our goal is to provide intense treatment for metabolic diseases, such as diabetes and dyslipidemia, that increase risk for cardiac disease. We utilize a team approach through our physicians, pharmacists, nurse practitioners, and cardiac nurse."

To accommodate a swelling patient roster, the clinic has boosted capacity by increasing the staff of physicians and nurse practitioners who commit to have appointments readily available for patients, a policy it has maintained despite significant growth.

"To improve the process of getting patients into the clinic, we do not require any previous clinic notes or signed referrals," Riche explained. "We accept physician referrals, but we will also take self-referrals. All we need is a phone call, and in most cases, we can see the patient within a week. If we have to keep working people in, we'll just increase the clinic day."

The clinic's primary objective is to provide risk management for patients' specific cardiometabolic syndromes while freeing family physicians to manage their patients' primary care and other health needs.

"People have primary care physicians. That's not who we are," said Riche, a board-certified pharmacotherapy specialist. "We are the specialists who take care of cardiometabolic disorders."

Clinic staff help patients manage conditions such as hyperlipidemia, obesity, impaired glucose tolerance, diabetes, gout, hypertension, fatty liver, and smoking.

"It can be overwhelming for a primary care provider to meet the guidelines for these disorders during a busy day while staying current on the literature," East said. "We hope to provide assistance to the primary care provider for all these chronic conditions."

Under the direction of Marion R. Wofford, MD, professor of medicine, the clinic provides the risk management necessary to prevent serious conditions such as heart attack, stroke and renal failure while also helping to improve patients' survival odds and quality of life.

"Our primary mission is clinical service," Riche said, "but we also support all three of the institution's missions. We assist in the education of both medical and pharmacy students and residents, and we are conducting several prospective and retrospective research studies for interested patients. We're striving to be a well-rounded program."

Clinical care, education and research are all important, said Riche, because Mississippi leads the nation in the incidence of cardiovascular disease, obesity and diabetes. Since "cardiometabolic" describes diseases that affect the heart, then obesity, diabetes, cholesterol problems, and hypertension fit into that category.

Providing "one-stop shopping" for all such diseases is a relatively new concept in the South – and across America. The Mayo Clinic in Rochester, Minn., represents one of the first programs to implement the concept of universal cardiometabolic treatment service. But that program does not include pharmacists as providers.

"We're on the forefront of the cardiometabolic agenda, and I'm proud to be a part of it," Riche said. "If someone in Mississippi has a problem with complex lipid disorders, diabetes and hypertension, or needs to talk to someone about how to improve their lifestyle, we can help."

The clinic also serves as a "gateway" for patients to enter the University Medical Center system. Riche said patients with additional or complex health needs are often referred to other UMHC departments, such as cardiology, ophthalmology, endocrinology, or surgery.

Eventually, East and Riche hope to mold the clinic into one of the nation's leading cardiometabolic centers.

"We have the commitment to be the best cardiometabolic program in the southeast," Riche said. "We want to help people in Mississippi help themselves by understanding their risks for heart disease."

Tags:

Cardiometabolic Clinic, cardiometabolic disorders, Daniel M. Riche, Honey E. East, Marion R. Wofford, University of Mississippi Health Care Pavilion

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