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Role of a pharmacist in a seizure clinic.

The involvement of a clinical pharmacist in a Department of Veterans Affairs seizure clinic is described. A pharmacist who had served a residency in ambulatory care began working in a seizure clinic in 1988 after obtaining the cooperation of a neurologist interested in a multidisciplinary approach to patient care. A clinical protocol was developed to guide the pharmacist's participation. The seizure clinic is staffed by the clinical pharmacist, a pharmacy resident, and a neurologist and is currently treating 162 adult male veterans. Of the 162 patients, 159 are receiving anti-convulsant therapy. The role of the pharmacist is to assist the neurologist in providing patient-care services. The pharmacist interviews each patient, performs a neurological assessment and mental status evaluation, and orders laboratory tests. Information is recorded by the pharmacist on a history form and a subjective and objective assessment and planning form. The pharmacist presents the findings to the neurologist, and the patient is then interviewed jointly by the pharmacist and the neurologist. Between appointments, the pharmacist follows up on abnormal laboratory test values and informs patients of any necessary dosage adjustments. More time is available for patient care, there has been an increase in the detection of adverse drug reactions and disease states, and record keeping has improved. A pharmacist assumed a primary-care role in a seizure clinic by interviewing and assessing patients, ordering laboratory tests, and participating in the selection and adjustment of anticonvulsant therapy.