Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers.
*Quality Improvement; Adolescent; Adult; Aged; Antihypertensive Agents/*therapeutic use; Blood Pressure; Chronic Disease – Drug Therapy; Chronic Disease – Therapy; community health centers; Community Health Centers; Data Analysis Software; Descriptive Research; Descriptive Statistics; Diabetes Education; Diabetes Mellitus – Therapy; Diabetes Mellitus/*drug therapy/metabolism; Female; Financing; Funding Source; Glycated Hemoglobin A/metabolism; Glycosylated; Government; Health Services; Hemoglobin A; Hospital/*methods; Human; Humans; Hypertension – Therapy; Hypertension/*drug therapy; Hypoglycemic Agents/*therapeutic use; Male; Medically Underserved; Medication Management; medications; Middle Aged; Multicenter Studies; Ohio; Outcome Assessment (Health Care); Outcomes (Health Care); Patient Education as Topic; Pharmacists; pharmacy; Pharmacy Service; Pilot Projects; Pilot Studies; primary care; program evaluation; Prospective Studies; Referral and Consultation; Self Care; Young Adult
INTRODUCTION: Appropriate management of chronic diseases, including proper use of medications, can lead to better disease control, decrease disease-related complications, and improve overall health. Pharmacists have been shown to positively affect chronic disease outcomes through medication therapy management (MTM). The primary objectives of this project are to increase the number of patients with (1) A1c in control and (2) blood pressure in control; secondary objectives are to (3) describe number and type of medication-related problems identified and resolved by pharmacists providing MTM in Federally Qualified Health Centers (FQHCs), (4) identify potential (pADEs) and actual adverse drug events (ADEs), and refer patients to diabetes self-management education classes, as needed. METHODS: This multisite, prospective, descriptive pilot study engaged three FQHC sites with distinct models of established pharmacist MTM services to care for patients with uncontrolled diabetes and/or hypertension. Data were reported in aggregate regarding primary and secondary outcomes. RESULTS: As of December 2015, 706 patients were enrolled in the project. Of the 422 with uncontrolled diabetes, 52.84% (n = 223) had an A1c \textless9%; 72 patients (17.06%) achieved an A1c between 8% and 9%, 19.19% (n = 81) of patients achieved an A1c \textless8% and \textgreater/=7%, and 16.59% (n = 70) of patients achieved an A1c \textless7%. The percentage of patients with blood pressure \textless140/90 mm Hg improved to 65.21%. CONCLUSION: Pharmacist-provided MTM can improve chronic disease intermediate outcomes for medically underserved patients in FQHCs.
Rodis Jennifer L; Sevin Alexa; Awad Magdi H; Porter Brianne; Glasgow Kyle; Hornbeck Fox Carrie; Pryor Barbara
Journal of Primary Care & Community Health
2017
2017-10
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<a href="http://doi.org/10.1177/2150131917701797" target="_blank" rel="noreferrer noopener">10.1177/2150131917701797</a>
Prioritization of Pediatric Palliative Care Field-Advancement Activities in the United States: Results of a National Survey.
curriculum; financing; funding; palliative care; pediatric; quality of health care
BACKGROUND: The field of pediatric palliative care (PPC) continues to encounter challenges and opportunities to improving access to high-quality PPC services. In early 2019, a workshop identified eleven potential "next step" actions, and subsequently a national survey-based poll of members of the PPC community was conducted to prioritize these potential actions in terms of their "actionable importance." METHODS: Invitations to the survey were distributed in October 2019 to interdisciplinary PPC health care professionals via email to two major listservs, one hosted by the Section of Hospice and Palliative Medicine of the American Academy of Pediatrics, the other by the Center to Advance Palliative Care. Respondents rated the "actionable importance" of items relative to each other via a discrete choice experiment. Median importance scores are reported for each item. RESULTS: 177 individuals responded to the survey. The majority (62.2%) were physicians, with nurses (16.4%), advanced practice nurses (7.9%), and social workers (7.3%) being the other most common responders. The top 5 potential actions, in descending rank order, were: Determine what parents value regarding PPC (median score of 17.8, out of a total score of all items of 100); Define and disseminate core primary PPC curriculum (median, 15.3); Develop PPC national representation strategy and tactics (median, 12.3); Create PPC-specific program development toolkit (median, 10.9); and, Analyze payment and financing ratios (median, 9.6). CONCLUSIONS: Those seeking to advance the field of PPC should take into account the findings from this study, which suggest that certain actions are more likely to have a beneficial impact on moving the field forward.
Feudtner Chris;Faerber JA;Rosenberg AR;Kobler K;Baker JN;Bowman BA;Wolfe J;Friebert S
Journal Of Pain And Symptom Management
2021
2021-01-21
journalArticle
<a href="http://doi.org/10.1016/j.jpainsymman.2021.01.007" target="_blank" rel="noreferrer noopener">10.1016/j.jpainsymman.2021.01.007</a>