August 2024 – Phone line disconnected after I introduced myself and shared that I was calling to check in about his medications
July 2024 – Left voicemail
June 2024 – Left voicemail
…
These were the notes I reviewed in patient BK’s profile as I prepared to engage him in a CPESN payor program hypertension program. After noticing the growing list of unreturned call attempts, I doubted that I would have the opportunity to actually speak to BK. However, I picked up the phone and dialed his number anyway. Unsurprisingly, the call went to voicemail.
I left a brief voicemail asking BK to please call the pharmacy back at his earliest convenience and went back to my daily workflow. About an hour later, one of the pharmacy technicians let me know that there was a patient on the phone returning my earlier call. I was shocked and delighted that it was BK!
Medication List:
I focused my conversation with BK on his adherence to his hypertension medication, amlodipine 5 mg one tablet daily. I started by asking the typical adherence questions:
How are you taking this medication?
In the past week, how many doses of your medication have you missed?
How do you remember to take your medications (pill box, alarms, etc.)?
BK answered that he was taking his amlodipine as directed and he doesn’t usually miss doses because he uses a pill box at home. Thinking this was a pretty straightforward phone call so far, I asked my last question: have you been experiencing any side effects of this medication? I elaborated on this question a bit, asking specifically if he ever experienced symptoms of hypotension, such as feeling lightheaded, dizzy, weak, or having blurred vision?
BK thought about it for a second and then said “yes.” He said that for the past month or so, he sometimes felt lightheaded and dizzy and had to sit down. He even had blurred vision once. I followed up by asking if he took his blood pressure when he experienced these episodes to see if it was low and if so, how low it was. He replied “no, I don’t have a blood pressure cuff at home.”
At this point, I asked if I could discuss our conversation with my pharmacist preceptor, Dr. Nicole Pezzino, to see if he would qualify for a blood pressure cuff and develop the best plan for him. After talking with Dr. Pezzino, she shared that BK would be eligible for a blood pressure cuff through his health plan at no charge! I just needed to get a prescription from his provider so we could submit the claim. Excited about this opportunity, I immediately contacted his provider’s office, they shared my excitement at this opportunity and immediately provided a verbal prescription for a blood pressure cuff. We processed it and filled it that day!
I called BK back and shared with him that we had a blood pressure cuff filled and ready for him to pick up for no charge! He thanked me and said he would pick it up next week when he came to the pharmacy for his other medications. Currently, we are expecting him in a couple days at the pharmacy and we will educate him on proper blood pressure technique for using his cuff. We shared our goals with him and encouraged him to check his blood pressure and document his readings so he can share with his provider to better guide treatment and prevent episodes of hypotension.
Looking back, this experience taught me a valuable lesson. It’s important to keep making an effort to connect with patients. You never know when a patient’s circumstances or attitudes may change and they may be open to having a conversation with you. If I had let the long list of unanswered voicemails deter me from reaching out to BK, I never would have been able to make this intervention! It was rewarding to see how persistence pays off and how simple conversations can drive meaningful interventions.
Written by: Grace O'Toole, PharmD Candidate 2025
Wilkes University, Nesbitt School of Pharmacy
Preceptor: Nicole Pezzino, PharmD, BCACP, BC-ADM, CDCES