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Excellence in Pharmacy Practice: Walgreens’ Nicholas meets complex, chronic care needs

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AUSTIN, Texas — As a Walgreens specialty pharmacy manager, Casey Nicholas provides high-touch care for patients with complex, chronic care needs.

Her location serves patients throughout their health care journey — those who need drugs for different stages of HIV, cancer, organ transplants and some neurological diseases.

Organ transplant patients need extensive medication therapy management. “I have one pharmacist who is amazing with these patients and works closely with the hospital and clinics to make sure the patient care continuum is seamless,” she says. This pharmacist provides in-depth counseling so that patients understand why they are taking these medications and how to take them. Patients also love that they can access these services locally and not at a hospital. With pharmacists being one of the most trusted health care professionals, the opportunity to provide these services to our patients is fantastic.”

Casey Nicholas

Patients also appreciate Walgreens helping them plan ahead. It’s essential to remain adherent with specialty medications, and not taking them as prescribed can lead to complications, so Walgreens works closely with its specialty patients. “In our counseling sessions, we emphasize the huge role these medications play, and follow up regularly, as the dosage can change frequently,” Nicholas comments.

She takes pride in providing all this, but what excites her most is what these services could look like in the future. Walgreens is expanding pharmacy care offerings to include many new health care services. For example, it’s piloting test-and-treat programs under which pharmacists can prescribe certain medications, such as Paxlovid for COVID or PrEP to help prevent HIV.

Nicholas began her pharmacy career at Walgreens seven years ago, and she has seen people’s viewpoints before, during and at this point in the pandemic. “For me, the pandemic helped the public appreciate how accessible pharmacists are in a very meaningful way,” she says. “Walgreens was open throughout the initial COVID shutdowns. We were there when patients had questions, when they were scared when hospitals were closing or when they couldn’t connect with their providers. I think now we really are seen as part of their health care team.”

Pharmacists were also one of the first health care professionals to provide COVID-19 vaccines. While pharmacists have provided most routine vaccinations for some time, COVID opened the public’s eyes to the extent that they can help meet these needs. Nicholas was part of the first team that provided COVID-19 shots in Texas. Team members worked in long-term care facilities, and people saw them as additional health care partners, offering services beyond dispensing medications.

Walgreens’ micro-fulfillment centers free up a lot of time for pharmacists by filling scripts for maintenance medications. This allows technicians and pharmacists to spend more time with patients and have more in-depth conversations, which can help improve their care. While Nicholas was at a pharmacy that’s part of a Village Medical at Walgreens, she noticed how the operation could simplify matters by integrating the primary care and pharmacy experience for comprehensive care and ongoing support.

Throughout the course of each patient’s health journey, Walgreens partners closely with the entire health care team, but does so especially when there are dose changes and reported side effects. At the specialty site, the company has developed close relationships with health care providers to make sure the pharmacy can connect with them quickly and efficiently. At Village Medical at Walgreens, pharmacists work directly with Village Medical primary care physicians and advanced practice providers (APPs). This coordinated care approach allows pharmacists to spend less time on administrative tasks and more time focused on providing care, which can save patients time, effort and money. “These factors are so important because the number of people living with multiple chronic health conditions is growing, and they need convenient access to affordable, quality health care,” Nicholas points out.

Foundational to patient care is education, she adds. “We counsel patients during all our calls as well as within the traditional community pharmacy setting. In specialty pharmacies, we see patients with complex or rare illnesses and conditions who need more touchpoints, so we spend a lot of time discussing their condition, medication, the importance of adherence and how to manage everything throughout their journey.” Patients can also reach out to Walgreens specialty online and on the phone.

Nicholas’ favorite parts of her job are helping people and constantly learning. “When I think about the moments where I’ve helped a patient and really made a difference in their life, it grounds me in why I come to work each day,” she says.

She was drawn to the pharmacy profession because it is so patient-facing, and she wanted the opportunity to help care for patients. She served as a Walgreens staff pharmacist in Montana before becoming a pharmacy manager. After moving to Austin she worked at several Walgreens pharmacies, one of which was at a Village Medical at Walgreens. As a specialty pharmacy manager she oversees a pharmacy manager, two staff pharmacists, six full-time technicians and three or four part-time technicians.

When she first came to Austin, Nicholas’ health care supervisor, Aimee Lusson, helped her pursue multiple opportunities. “She allowed me to take the lead when we launched our first COVID testing site,” Nicholas says. “She has been an incredible sponsor and wonderful example of leadership, for which I’m very grateful.”


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