The Role of the Pharmacist and Pharmacogenomics in the Care of Seriously Ill Patients

Inclusion Criteria: * English speaking * Age 18 years and older * Palliative Medicine is consulted for the first time in either the outpatient setting for symptom management and plan to continue to follow up with the Palliative Medicine team in the outpatient setting for the foreseeable future. * Insurance accepted at Mayo Clinic Arizona. * Live within metro Phoenix area. Exclusion Criteria: * Vulnerable adults * Under 18 years of age * Pregnant Patients * Subjects whose medical insurance requires use of specific pharmacies * Non English Speaking Patients * Patients that lack capacity for medical decision making * Patients who live outside the metro Phoenix area * Patients who are lost to follow up secondary to enrolling in hospice, die or failure to show or answer surveys within 2 months of enrollment. * Patient with uncontrolled concurrent illness including psychiatric illness, or situations that would limit compliance with the study requirements or the ability to willingly give written informed consent. * Patient's previously established within the Palliative Medicine Clinic who receive ongoing Palliative Medicine services.