Five Questions With: Dr. Christopher Durigan

Dr. Christopher Durigan, director of clinical pharmacy at Thundermist Health Center, was recently recognized by the National Association of Community Health Centers with the Geiger Gibson Program Emerging Leader Award.

The annual award is presented to young emerging leaders in community health who are nominated by community health centers and primary care associations.

Since joining Thundermist two years ago, Durigan has helped establish protocols allowing pharmacy technicians to manage provider refill requests, and was instrumental in the passage of a bill that permits community health centers to distribute naloxone.

PBN: How have you used your role as a pharmacist to help make an impact on the state’s opioid crisis?

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DURIGAN: Last year, I was honored to participate in an ad hoc workgroup led by Sen. Joshua Miller to address barriers to accessing naloxone. Thundermist was among the organizations advocating for the distribution of naloxone to at-risk patients at the point of care. We wanted to be sure patients can leave our health center with the life-saving medication.

I also used my knowledge as a pharmacist to train staff on how to use naloxone. With the help of our other clinical pharmacist, we screen our patients for medication and disease interactions that put them at high-risk for accidental overdose and suggest interventions to reduce this risk.

PBN: When you joined Thundermist Health Center two years ago, what was your top priority?

DURIGAN: I wanted to help patients. There is an incredible need for medication and disease education among patients at federally qualified health centers. There are many external barriers that prevent our patients from accessing their medications. Our patients are medically and socioeconomically complex. My priority was, and continues to be, working collaboratively with the patient care team to address these concerns and provide comprehensive, affordable, high-quality care.

PBN: How have you found ways to work with providers to improve patient care?

DURIGAN: At Thundermist the care team is comprehensive and includes physicians, nurse practitioners, medical assistants, nurses, clinical pharmacists, clinical social workers, social services staff, nurse care managers, community health workers, psychiatric prescribers, and dental providers. I work collaboratively with providers to help manage diabetes, using my knowledge of the most evidence-based medication regimens to optimally control the disease and prevent complications. I follow up with patients in between their visits with providers, adjusting their medications along the way in collaboration with their provider, and assessing their diet and exercise adherence. That way, by the time they see their provider again, they have already shown an improvement and the provider has more time to focus on other aspects of their care.

PBN: Have rising prescription drug prices, widespread opioid abuse and increasing warnings about overuse of antibiotics changed how you approach your job?

DURIGAN: Rising prescription medication prices mean I am vigilant about using generic medications whenever possible. I also ask all patients I meet with if they have difficulty affording the medications prescribed to them. There are programs we can refer patients to and help them access the medications they need.

I am heavily involved in the steering committee that directs our medication-assisted treatment services. I consult with many of our providers who prescribe MAT.

PBN: You’ve worked with transgender people to improve the safety and efficiency of hormone treatments – what changes to state law did you help make on this issue?

DURIGAN: Jayeson Watts, our Trans* Health Team Program director, informed me of an issue he kept encountering when I first started at Thundermist. Patients were being required by pharmacies to re-use one milliliter testosterone vials and reported they could not get enough medication out of these vials to last a month. This requirement seemed unsafe, and I began researching the issue. Upon speaking with multiple testosterone manufacturers, they all reported the same thing – these one milliliter vials are not intended to be used more than once, despite labels lacking a “single use” designation. The reuse of the vial has negative safety and therapeutic implications. I reported this to the Food and Drug Administration with the help of the Rhode Island Board of Pharmacy. Thundermist began advocating with state legislators and a bill was passed excluding hormone-replacement medications (i.e. testosterone) from the Controlled Substances Act’s quantity limitations. This means patients can now fill a larger, multi-use vial every month, or multiple single-use vials. With this law change, patients using testosterone should now have a much easier time obtaining the appropriate amount of medication per month and administer it in a much safer fashion.

Elizabeth Graham is a PBN staff writer. Email her at Graham@PBN.com.