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FUNCTIONAL MEDICINE IN PHARMACY PRACTICE

Suzanne Keyes, PharmD, FACA, IFMCPKeyes’ Compounding & 180 Wellness

Elk City, OK

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DISCLOSURESit’s about transparency

I, Suzanne Keyes, declare no conflicts of interest or financial interest in any product or service

mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

LEARNING OBJECTIVES

Identify target patient

populations and outline

marketing strategies

and themes for expansion into

functional medicine.

Discuss the functional medicine

market and the health care

professions involved who are

potential partners for pharmacy.

Discuss an appointment-

based model for

functional medicine,

pharmacy workflow & add-on

revenue opportunities.

it’s about education

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• Independent community pharmacy represent 36% of U.S. retail pharmacies and are capturing $80 billion dollars in the current marketplace

BUT• Below-cost reimbursements, exacerbated by DIR fees in Medicare Part D,

contribute to gross margins falling by 5% over the past five years

AND• 52% of total prescriptions are covered by the Medicare Part D and Medicaid

programs. (10,000 people a day are turning 65 years old)

DID YOU KNOW?it’s about the facts

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TOP 5 MEDICINES IN THE U.S.based on number of monthly prescriptions written in millions

SYNTHROID

CRESTOR

VENTOLIN

NEXIUM

ADVAIR

18.218.2 13.713.721.421.4 15.215.221.521.5

https://www.webmd.com/drug-medication/news/20150508/most-prescribed-top-selling-drugs

THE PHARMACIST’S ROLE NOWit’s about change

• The Role of the Pharmacist as Part of a Multidisciplinary Cancer Care Teamhttps://www.specialtypharmacytimes.com/publications/specialty-pharmacy-times/2018/may-2018/the-role-of-the-pharmacist-as-part-of-a-multidisciplinary-cancer-care-team

• The Pharmacist's Role in Educating Patients on Medical Cannabis Usehttps://www.pharmacytimes.com/conferences/ashp-summer-2018/the-pharmacists-role-in-educating-patients-on-medical-cannabis-use

• Use of Pharmacogenomics Data within Pharmacy Practicehttps://pharmacist.com/2018-apha-policy-topics

• The Pharmacist’s Role in Educating the Health-Care Team About Adverse Effects of Immune Checkpoint Inhibitorshttp://www.ascopost.com/issues/may-25-2018/pharmacist-role-in-educating-the-health-care-team/

• Pharmacists called to take lead in pharmacogenomics—the bridge to personalized medicinehttps://www.pharmacist.com/article/pharmacists-called-take-lead-pharmacogenomics-bridge-personalized-medicine

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• The results of 11 studies published since 1978 indicate that technicians' accuracy in performing final dispensing checks is very comparable to pharmacists' accuracy Adams AJ, Martin SJ, Stolpe SF. "Tech-check-tech": a review of the evidence on its safety and benefits. Am J Health Syst Pharm. 2011;68(19):1824-1833.

• California, Colorado, Idaho, Iowa, Kansas, Kentucky, Michigan, Minnesota, Montana, North Dakota, South Carolina, Washington, Maryland, North Carolina, and Oregon

TECH CHECK TECH (TCT)it’s about trust

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The Standard American Diet01

Environmental Exposures02

Chronic Stress03

Nutrient Depletion04

RANDOM PIECESit’s about creating a picture

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CONVENTIONAL MEDICINE LOOKS AT:

FUNCTIONAL MEDICINE LOOKS AT:

IRRITABLE BOWEL SYNDROME

Biologics; increase fiber; stress reduction

Nutrient deficiencies; food sensitivities; inflammation; underlying parasitic/fungal/bacterial infections; hormone imbalances

DEPRESSION/ANXIETY Anti-depressants;anxiolytics; counseling

NT pathways; inflammation; nutrient deficiencies; hormone imbalances (including sex steroids, insulin and thyroid); gut microbiome

MIGRAINE HEADACHES Medications; restHormone imbalances; thyroid; food sensitivities; toxic exposure; nutrient deficiencies

CHRONIC FATIGUE SYNDROME

Stress management; rest; medications for symptoms

Mold/fungal exposures; nutrient deficiencies; thyroid; hormone imbalances

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MEDICATION / CLASS OF MEDICATION DEPLETES CAUSING

AMOXICILLIN

Lactobacillus acidophilus,Bifidobacterium

bifidum, biotin, folic acid, inositol, vitamins B1, B2, B3, B6, B12, and K

Dybiosis, neurotransmitterimbalance, weight gain,

restlessness, ADHD, anxiety, sleep disturbance, fatigue, thyroid

dysfunction

METHYLPHENIDATE Magnesium

Depression, Type II diabetes, ADHD, PMS, Asthma, Epilepsy, Sleep disturbances, Migraines, Angina, HTN, Arrhythmias, Osteoporosis

ORAL / INHALED CORTICOSTEROIDS

Amino acids, A (beta-carotene) B6, B12, C, calcium, chromium, D, DHEA,

Folate, magnesium, melatonin, protein, potassium, selenium, zinc

Neurotransmitter imbalance, blood sugar dysregulation, restlessness,

anxiety, sleep disturbance, fatigue, dysbiosis, thyroid dysfunction

SSRIs MelatoninIodine

Irritability; restlessness, sleep disturbance, thyroid imbalances

CLONIDINE Melatonin Irritability; restlessness, sleep disturbance

KEYES’ COMPOUNDING& 180 WELLNESSit’s about differentiation

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• FIELDS PHONE CALLS • DIRECTS CONSULT & TEST KIT SALES• UPDATES EDUCATIONAL PAMPHLETS

• DIRECTS NUTRITIONAL SALES• EDUCATES PATIENTS ON FOOD

PLANS, CBD, DIND

• COUNSELS PATIENTS• CONDUCTS CONSULTS• EDUCATES PRACTITIONERS

25%50%

25%

CLERKTECHNICIANPHARMACIST

CHANGE PHARMACY HEIRRARCHYit’s about reinventing yourself

THYROIDHerbals

GlandularsCofactors

GUT HEALTHProbiotics

Betaine/PepsinDigestive Enzymes

NEUROSleep

Mood Boosters

ADRENALSGlandulars

Adaptogens Cofactors

SHELF POSITIONINGit’s about creating the need for education

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COUNSELING OR CONSULTING?it’s about assigning value

THE PARRATA RULEit’s about discernment

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Jeffrey Bland, MD www.jeffreybland.comJill Carnahan, MD www.flatironmedicine.comChris Kresser, Lac www.chriskresser.comMark Hyman, MD www.drhyman.comWill Cole, DC www.drwillcole.comWestin Childs, DO www.restartmed.comJolene Brighten, ND www.drbrighten.comKelly Brogan, MD www.kellybroganmd.comSteven Gundry, MD www.gundrymd.comBen Lynch, ND www.mthfr.net

www.drbenlynch.com

A FEW OF MY MENTORSit’s about who you know

Know the conditionKnow the questions to askKnow the studies, statistics & evidenceKnow the pathwayKnow the triggers/exposures/foodKnow the labs/biomarkersKnow optimal rangesKnow genetic SNPs existKnow the supplements

:it’s about what you know

WHAT’S INVOLVED?

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KNOW YOUR WORTH

BUT ABOVE ALL ELSEit’s about what you know

it’s about your resourcesWHERE DO I FIND OUT MORE?

https://www.ifm.org

https://kalishinstitute.com/blog/become-functional-medicine-practitioner/

https://www.functionalmedicineuniversity.com

https://www.uws.edu/human-nutrition-functional-medicine/

https://www.functionalmedicinecoaching.org

https://www.schoolafm.com

https://smhs.gwu.edu/integrative-medicine/

https://www.a4m.com

https://www.integrativenutrition.com

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