TY - JOUR
T1 - Impact evaluation of a four-year academic-community partnership in provision of medication management and tertiary prevention services for rural patients with diabetes and/or hypertension
AU - Anderson, Elizabeth J.
AU - Axon, David Rhys
AU - Taylor, Ann M.
AU - Towers, Victoria
AU - Warholak, Terri
AU - Johnson, Melissa
AU - Forbes, Stephanie
AU - Manygoats, Teresa
N1 - Funding Information:
This work was supported by the Grant or Cooperative Agreement Number, DP004793, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. This work also was supported, in part, by SinfoníaRx.
Funding Information:
Elizabeth J. Anderson, David Rhys Axon, Ann M. Taylor, & Terri Warholak received funding from SinfoníaRx. Stephanie Forbes is an employee of SinfoníaRx. Melissa Johnson, Ann M. Taylor and Terri Warholak received funding from the Arizona Department of Health Services. Teresa Manygoats is employed by the Arizona Department of Health Services. Appendix A
Publisher Copyright:
© 2019 The Author(s)
PY - 2020/3
Y1 - 2020/3
N2 - Medication therapy management (MTM) services, including targeted, pharmacist-delivered, tertiary prevention interventions, were provided to rural patients with chronic diseases via an academic-community partnership. The purpose of this investigation was to evaluate the overall program and pre/post patient outcomes from this four-year, multi-site collaboration. Five community health sites collaborated with a university-based MTM provider to deliver services in Arizona (2012–16). Eligible patients: were 18 or older (median 65 years); had a diagnosis of diabetes and/or hypertension; and resided in a rural community. Participants received an initial telephone consultation with the MTM pharmacist; follow-up consultations were conducted after 30 or 90 days for high- and low-risk patients, respectively. Community partner staff collected clinical data and addressed pharmacists’ recommendations. Descriptive analysis and bivariate analyses of pre- and post-intervention results were conducted. Most (n = 410, 70%) of the 577 participants receiving an initial and follow-up consultation with the MTM pharmacist had both diabetes and hypertension. These individuals showed statistically significant improvements in fasting blood glucose (p < 0.0001), hemoglobin A1C (p = 0.0082) and systolic blood pressure (p = 0.009) while those with only one condition did not demonstrate significant changes. While the pre/post changes in chronic disease control indicators were statistically significant, the clinical significance was low to moderate. Patients with both comorbid diabetes and hypertension experienced benefit from collaborative, targeted MTM pharmacist-delivered, tertiary prevention interventions in tandem with community-based pharmacy resources. This multi-site MTM program showed promise in increasing patients’ use of these services, yet effective strategies are needed to expand recruitment of eligible patients in the future.
AB - Medication therapy management (MTM) services, including targeted, pharmacist-delivered, tertiary prevention interventions, were provided to rural patients with chronic diseases via an academic-community partnership. The purpose of this investigation was to evaluate the overall program and pre/post patient outcomes from this four-year, multi-site collaboration. Five community health sites collaborated with a university-based MTM provider to deliver services in Arizona (2012–16). Eligible patients: were 18 or older (median 65 years); had a diagnosis of diabetes and/or hypertension; and resided in a rural community. Participants received an initial telephone consultation with the MTM pharmacist; follow-up consultations were conducted after 30 or 90 days for high- and low-risk patients, respectively. Community partner staff collected clinical data and addressed pharmacists’ recommendations. Descriptive analysis and bivariate analyses of pre- and post-intervention results were conducted. Most (n = 410, 70%) of the 577 participants receiving an initial and follow-up consultation with the MTM pharmacist had both diabetes and hypertension. These individuals showed statistically significant improvements in fasting blood glucose (p < 0.0001), hemoglobin A1C (p = 0.0082) and systolic blood pressure (p = 0.009) while those with only one condition did not demonstrate significant changes. While the pre/post changes in chronic disease control indicators were statistically significant, the clinical significance was low to moderate. Patients with both comorbid diabetes and hypertension experienced benefit from collaborative, targeted MTM pharmacist-delivered, tertiary prevention interventions in tandem with community-based pharmacy resources. This multi-site MTM program showed promise in increasing patients’ use of these services, yet effective strategies are needed to expand recruitment of eligible patients in the future.
KW - Diabetes
KW - Hypertension
KW - Intersectoral Collaboration
KW - Medication Therapy Management
KW - Rural Health Services
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U2 - 10.1016/j.pmedr.2019.101038
DO - 10.1016/j.pmedr.2019.101038
M3 - Article
AN - SCOPUS:85077648874
SN - 2211-3355
VL - 17
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 101038
ER -