Clinical Pharmacist Specialist – Outpatient Infectious Diseases/HIV
The Miriam Hospital Infectious Disease & Immunology Center
Location: Providence, RI
Contact:
Amy Brotherton, PharmD, AAHIVP, BCIDP
Clinical Pharmacy Coordinator – Ambulatory Infectious Diseases
The Miriam Hospital Infectious Diseases and Immunology Clinic
180 Corliss Street
Providence, RI, 02904
amy.brotherton@lifespan.org
Position Summary:
Lifespan – The Miriam Hospital (TMH) is seeking a pharmacist specialist whose primary role will be providing infectious disease (ID) focused pharmacotherapy services to patients in the ambulatory care setting. This position will build upon current innovative pharmacist-driven services dedicated to optimizing outpatient antimicrobial therapy and the prevention and treatment of HIV and HCV.
Position activities include:
- Co-management of patients with HIV through a collaborative practice agreement (CPA), alongside ID providers including but not limited to:
-
- Pharmacist-driven rapid initiation of ART in individuals newly diagnosed with HIV
- Pharmacist-driven ART optimization, including long acting injectable cabotegravir/rilpivirine initiation
- Assistance with polypharmacy, complex drug-drug interactions, and medication adjustments
- Medication adherence counseling and support
- Assistance with complex cases of HIV, including multi-drug resistant HIV and opportunistic infections
- Assistance with primary care management for patients with HIV
- Co-management of patients with hepatitis C through a CPA alongside ID providers
- Co-management of HIV prevention services, including pharmacist-driven injectable PrEP through a CPA alongside ID providers
- Attend Monday morning Immunology (HIV) Signout Rounds on admitted patients, act as a resource to the inpatient attending regarding drug-drug interactions or management questions
- Support pharmacy services dedicated to the outpatient parenteral antimicrobial therapy program alongside our ID providers and nursing staff
- Serve as a liaison between the inpatient and ambulatory settings, and between the providers and the on-site outpatient Lifespan pharmacy
- Education-related activities include:
-
- Serve as a preceptor to PGY1 pharmacy residents, PGY2 ambulatory care residents, APPE pharmacy students, and infectious diseases physician fellows
- Provide didactic lectures to local pharmacy, nursing, and physician assistant schools
- Provide in-services to pharmacists, providers, nurses, and other healthcare staff
- Opportunity for faculty appointment as an Assistant Professor through Brown University’s Alpert Medical School
Qualifications
- Doctor of Pharmacy degree
- Eligible for pharmacist licensure in Rhode Island
- Completed an ASHP-Accredited PGY1 pharmacy residency and an ASHP-Accredited PGY2 in infectious diseases or applicable residency or equivalent experience
- Ability to function independently and collaboratively within a team setting. Highly motivated; effective communication, problem solving, and organizational skills required
ID Clinical Pharmacy Team at Lifespan:
We currently have six Clinical Pharmacist Specialists in Infectious Diseases across the Lifespan System: four Antimicrobial Stewardship/Inpatient ID pharmacists (one specialist at The Miriam Hospital, one at Newport Hospital, and two at Rhode Island Hospital) and two ID/HIV pharmacists at The Miriam Hospital ID & Immunology Center. The ID pharmacists work closely as a team and collaborate with one another to ensure optimal transitions of care between the inpatient and ambulatory settings. Additionally, the team works together on projects, guidelines, protocols, and implementation of system-wide initiatives. The ID pharmacists are members of the Antimicrobial Stewardship Subcommittee and attend Infection Control meetings regularly.
The Miriam Hospital Infectious Diseases and Immunology Center
The Miriam Hospital Infectious Diseases and Immunology Center serves as the outpatient infectious diseases clinic for the Lifespan System. The Center has several different components, including:
- HIV Specialist and Primary care
- Hepatitis C and Hepatitis C/HIV co-infection specialty care
- Hepatitis B and Hepatitis B/HIV co-infection specialty care
- General Infectious Diseases consultation
- Outpatient parenteral antimicrobial therapy (OPAT)
- Rhode Island’s only Sexually Transmitted Infection (STI) clinic
- Rhode Island’s tuberculosis treatment clinic (the RISE Clinic)
The Infectious Diseases and Immunology Center is the largest provider of HIV care services between New York and Boston and serves over 1,900 people living with HIV/AIDS (PLWHA) annually (about 70% of the HIV-positive population of Rhode Island). It is a Ryan White funded clinic and has a large Ryan White staff, including ID pharmacists, pharmacy technicians, nurse case managers, social workers, a clinical therapist, a part-time psychiatrist, outreach workers, and advanced practice providers who specialize in medication assisted therapy (buprenorphine) for substance use disorder, OPAT, Lyme disease and tick-borne infections, HIV prevention, and HIV primary care. The Center also has a large outpatient ID (non-HIV) side, about half of the nearly 15,000 visits annually are non-HIV related, mostly OPAT, hepatitis C, and general infectious diseases related. The STI clinic sees an additional 4,000 patients per year. The clinic has an on-site pharmacy and laboratory.
The Brown Infectious Diseases division has 34 active faculty within the Lifespan system, of whom 21 actively see outpatients in the ID & Immunology Center. HIV-related outcomes at the Center are overall very impressive: >90% of the Center’s patients are virologically suppressed, and 99% are prescribed antiretroviral therapy. The key to success of the Center has been the integration of clinical care services with intensive medical case management services, nonmedical case management services, mental health, peer education, outreach, and pharmacy, which have supported the engagement and retention of patients with challenging social circumstances and complex comorbid illnesses. Additionally, The Miriam Hospital has the only inpatient HIV service in Rhode Island (called the Immunology Service). The service generally has between two and eight patients admitted and is a teaching service for the house staff from the Brown Internal Medicine residency program. An attending physician from the clinic serves as the admitting attending for this service.
Interested applicants should contact Amy Brotherton, PharmD, AAHIVP, BCIDP.
.gif){kind=logo}