EPISODE: 

Michael J Schuh 

Donna Bartlett, PharmD, BCGP, RPh 

The objective of this manuscript is to review an ambulatory care pharmacist service that evolved into a pharmacotherapy, polypharmacy service with multiple sub-models. The practice is located in a multi- specialty, tertiary care, destination medical clinic in Florida. Ambulatory care pharmacist services have evolved to demand expertise in multiple, specialized areas to address the more complex medical issues of the polypharmacy patient. Many of these patients are older than 65 years old with broad medical care needs. Growth and diversification of ambulatory care pharmacist services to evaluate the multitude of sophisticated medications, the continued direct-to-consumer commercialization and growth of dietary supplements, implementation of pharmacogenomic testing, in addition to new advances in clinical and laboratory technologies makes polypharmacy a viable pharmacist clinical specialty. With the broad knowledge base needed for these patients, a polypharmacy pharmacist may function as a pharmacology trouble shoot expert. 

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