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Alicia Garcia Afa
Genoa Healthcare
791 Chambers Road
Aurora, Colo. 80011
https://www.genoahealthcare.com/
AURORA, Colo. — It was a typical Friday when a patient stopped by the Genoa Healthcare pharmacy for his weekly medication pickup. However, this time he wasn’t acting like his usual upbeat self; he wore sunglasses and stood hunched over. Alicia Garcia Afa, the Genoa Healthcare pharmacist on site, had known this patient for over two years and immediately recognized something was off. Afa asked if he was OK, and in response, he asked if someone was behind him. When she told him no, he said he was being followed and a voice had told him to use opioids over the last few days.
Afa’s pharmacy, like most of Genoa’s pharmacies, is located directly within the mental health clinic where its patients receive their care. This integrated pharmacy model enables Genoa pharmacy teams to collaborate with clinic staff and providers to improve patient health outcomes.
Moving quickly, Afa and her team sprang into action. One of the pharmacy technicians alerted their on-site clinic partner about the situation while Afa and her pharmacy intern helped walk the patient to the front lobby where some members of the clinic’s crisis team were located. Meanwhile, the clinic’s crisis team called an ambulance and informed the patient’s psychiatrist of the situation. The patient would only respond to Afa and her team at first, so they served as the intermediary between him, the clinic staff and the paramedics.
“He recognized my voice,” said Afa. “Despite what he was going through in that moment, each time I put my hand on his shoulder I could tell he was still there.”
Genoa pharmacists have the option to complete specialized training in behavioral health, including the Mental Health First Aid training from the National Council for Mental Wellbeing. The course prepares Genoa pharmacists to identify and respond to signs of mental illnesses and substance use disorders, and to equip them with the knowledge to provide initial support to someone who may be experiencing a crisis. Afa credits the Mental Health First Aid training for giving her the confidence and skills to help the patient that day.
“Having the Mental Health First Aid training empowered me to ask the patient the hard, yet necessary, questions about his opioid use and hallucinations that may have previously felt out of my scope of practice,” said Afa. “I was able to remain calm and connect with him to get answers for the paramedics and clinic staff.”
After being discharged from the hospital a few days later, the patient went straight to the Genoa pharmacy to individually thank Afa and each pharmacy team member by name. He shared that he came to the pharmacy in autopilot mode that day because seeing Afa and her team was a part of his typical Friday routine.
The Centers for Disease Control and Prevention (CDC) estimates that in 2022, among the 4% of United States adults who needed opioid use disorder treatment, only 25% received recommended medications. The study noted that expanded communication about the effectiveness of medications for opioid use disorder is needed, and pharmacists and payors are at the forefront to support making medications available without delays.
“Knowing that the patient felt safe with my team and me in that moment of crisis reaffirmed why we do what we do every day,” said Afa.
Afa grew up watching her dad, who retired from pharmacy practice in December 2023, make a positive impact in the lives of others. She recalls admiring the difference her dad made in their community, with her fondest memories being the days he took her with him to the pharmacy. Afa knew she wanted to follow in her dad’s footsteps in pharmacy. As soon as she turned 18, she became a pharmacy technician, and she went on to become a pharmacist.
Genoa pharmacy teams help patients adhere to their medication plans by packaging medications in prefilled pill organizers, synchronizing prescription refills and customizing pharmacy care based on individual needs. The pharmacy’s partnership with clinics means each Genoa pharmacy provides personalized care, and pharmacists act as part of an integrated care team.
“When I first joined Genoa in 2019, a patient who did weekly medication pickups shared with me that she had been experiencing suicidal ideation,” said Afa. “We worked together to form a plan. When she ‘wasn’t feeling great’ — a code phrase we coined for when she was experiencing those thoughts — we would switch her weekly pickups to daily, so she could come check in with me.”
Genoa also supports clinic partners with medication-assisted treatment programs for substance use disorder in states that allow it. These programs combine compassionate, stigma-free care and therapy with medication that can aid in recovery.
Afa makes it a point to build a relationship with every patient who walks through her pharmacy door, whether it’s assisting patients with staying on their medications or simply being a familiar face every Friday.
“We’re here to support, to help, to care for our patients,” said Afa. “We’re not here to judge or to lecture. I make it clear to my patients that I will meet them exactly where they’re at, as best I can.”
