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Misty Gonzalez, PharmD, BCPP

A number of our CPNP members have passion for clinical work outside of their primary practice site. One area growing in interest amongst health care providers is expanding practice to help others in underserved countries during medical mission trips. In 2008, the American Association of Colleges of Pharmacy (AACP) declared globalization of pharmacy education a major initiative to be pursued by colleges of pharmacy. Due to these escalating academic interests, many healthcare programs are developing international endeavors. These may serve as opportunities for collaboration for interested pharmacists. 

In July of 2015, I traveled with pharmacy and medical students to Antigua, Guatemala, as a preceptor for a multidisciplinary advanced pharmacy practice experience. This academic venture was created through the SIUE School of Pharmacy in partnership with St. Louis University School of Medicine. This medical mission was made feasible by joining an active mission trip which had been ongoing for the past 10 years at the School of Medicine. For this trip, it was important to promote pharmacist services outside of dispensing services including physical assessments, vaccinations, medication therapy reviews, and point of care testing. This helped the collaborators better understand potential pharmacist contributions and welcome pharmacists’ participation.

Students and I spent time enhancing our medical Spanish and patient interview skills with one-on-one medical Spanish tutoring while we provided ambulatory care services partnered with Guatemalan physicians and nurses. We worked for four weeks in one of five public health clinics in Antigua and surrounding small towns. Longitudinal activities included updating and educating clinicians and patients on disease treatment and prevention. Daily clinic activities included taking histories and physicals, review of systems, administering vaccines, facilitating family planning, staffing the pharmacy, and identifying and addressing nutrition deficits by tracking heights and weights. In these clinics, consultations and treatments were free. However, due to political instability, clinicians and medications were not always available.

We organized two instant clinics during this mission trip as well. We partnered with the Antigua fire department to organize an outreach ambulatory care clinic in a rural mountain town which has difficulty accessing healthcare resources due to lack of availability of public transportation. Our second outreach clinic was organized for a nursing home where we assessed patients’ blood pressures, pulses, weights, fasting blood glucose, took medication histories and provided patient and staff education on treatment of hypertension and diabetes. Clinical duties included taking histories and physicals, review of systems, staffing a pharmacy, and facilitating therapeutic interchanges to optimally utilize donated medications.

In planning this experience, I learned that another CPNP member, Amy Werremeyer, PharmD, BCPP, was going to be on a medical mission trip in Guatemala with students from North Dakota State University School of Pharmacy. We were fortunate to have the opportunity to meet and discuss our varying clinical activities during the Guatemalan mission trips as our paths crossed in Antigua. Many pharmacists, including several CPNP members, participate in global endeavors of pharmacy practice. I would highly encourage pharmacists interested in international stewardship activities, including mission trips, to search for groups already participating in missions and inquire about collaboration. Including medical mission trip interest during networking conversations may provide excellent opportunities for future collaborations. Learn more about this medical mission trip here.

In the photos above:

  1. Clinic physician, medical students, pharmacist, pharmacy students, and first responders from the Antigua Fire Department pause for a photo following the conclusion of a successful instant clinic.
  2. Patient assisted by medical student in route to see the physician.
  3. CPNP members Amy Werremeyer and Misty Gonzalez meeting in Antigua.
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