Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers

Rodis, Jennifer L.; Sevin, Alexa M.; Awad, Magdi; Porter, Brianne L.; Glasgow, Kyle; Fox, Carrie Hornbeck; Pryor, Barbara

doi:10.1177/2150131917701797

Cited by 40 publications

(55 citation statements)

References 21 publications

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“…The cost of health care in the United States is the highest in the world, with total spending for 2014 reaching a new high of $3.1 trillion (18.3% of the total U.S. gross domestic product). [4][5][6][7][8] Evidence has shown that pharmacist-delivered disease state management, health promotion and disease prevention, MTM and the other aforementioned clinical services can improve patient outcomes and lower overall costs, while also alleviating the burden currently placed on the healthcare system by provider shortages and limited access to care. In 2014, 5.3% of the US population failed to obtain needed medical care due to cost.…”

Section: Introductionmentioning

confidence: 99%

“…[2] The average cost of a physician office visit is $89, while a visit to a hospital clinic or emergency department averages $245 and $406, respectively. [5][6][7][8] Many of the pharmacist-led clinical services, such as anticoagulation clinics or hypertension management programmes, are delivered in collaboration with physicians through collaborative practice agreements (CPAs), while some other services are delivered via pharmacist prescribing authority or statewide protocols such as naloxone, hormonal contraceptives, smoking cessation and immunizations. [2] There is a significant and urgent need to improve the quality, cost and accessibility of health care in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Community pharmacist-led clinical services: physician's understanding, perceptions and readiness to collaborate in a Midwestern state in the United States†

Gordon¹,

Unni

Montuoro³

et al. 2017

International Journal of Pharmacy Practice

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Community pharmacist-led clinical services: physician's understanding, perceptions and readiness to collaborate in a Midwestern state in the United States†

Gordon¹,

Unni

Montuoro³

et al. 2017

International Journal of Pharmacy Practice

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“…The prevalence of chronic diseases is rising, resulting in a greater health burden and increased polypharmacy with more risks for patients if therapy management and monitoring are not carried out optimally . Pharmacist intervention in the management of chronic conditions, such as in cardiovascular disease and diabetes mellitus, has the potential to ease the workload of physicians and allow them to dedicate more time to complicated cases, in the interest of patient safety and well‐being …”

Section: Discussionmentioning

confidence: 99%

“…Pharmacist prescribing for patients with hypertension and diabetes mellitus was agreed upon by seven of the nine expert panel members and by 27 of the 31 hospital pharmacists who participated in the study. Collaborative pharmacist‐led management services in hypertension and diabetes mellitus can help to improve monitoring and control of blood pressure and blood glucose, CVD risk factors, medication adherence and optimise therapy …”

Section: Discussionmentioning

confidence: 99%

“…Pharmacists are valued and accessible healthcare professionals positively contributing to the care of patients with chronic diseases . Pharmacists in the United States of America, Canada, the United Kingdom, Australia and New Zealand have been given the authority to prescribe medications for continuity of patient care and medication accessibility .…”

Section: Introductionmentioning

confidence: 99%

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Preparing for pharmacist prescribing in Maltese hospitals

Aquilina

Wirth

Pizzuto

et al. 2018

J Pharm Health Serv Res

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Objectives To develop and evaluate a framework for pharmacist prescribing in a hospital setting, assess differences between pharmacist and physician prescribing and analyse pharmacist perceptions on pharmacist prescribing. Methods A framework for pharmacist prescribing in hospital based on a collaborative drug therapy management approach was developed. Guidelines on three therapeutic scenarios, namely oral anticoagulation therapy, hypertension and diabetes mellitus, were compiled as part of the framework. The framework was validated by an expert panel consisting of five pharmacists and four physicians. A self‐administered questionnaire was developed and distributed to the expert panel to evaluate the framework. A case study relating to each therapeutic scenario identified was designed and given to the expert panel to assess differences between pharmacist and physician prescribing. The framework and the questionnaire were disseminated to all 62 pharmacists practicing in local public hospitals to evaluate the framework and their perceptions on pharmacist prescribing. Key findings All nine expert panel members strongly agreed or agreed that the proposed framework is well‐presented, clear and comprehensive, and seven strongly agreed or agreed upon its practicality for use in the hospital setting. Results of the case studies showed that pharmacists and physicians prescribed similar treatment when the correct diagnosis was established. Of the 31 pharmacists who completed the questionnaire, more pharmacists were willing to prescribe antihypertensive (n = 27) and antidiabetic medications (n = 27) compared to oral anticoagulation therapy (n = 20). Twenty‐seven pharmacists recommended further education to a specialised Masters or Doctorate level for pharmacist prescribing. Conclusions The proposed framework puts forward a well‐presented, comprehensive and practical system to prepare pharmacists for pharmacist prescribing in a hospital setting within a multidisciplinary team practice for chronic conditions.

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340B Participation and Safety Net Engagement Among Federally Qualified Health Centers

Watts,

McGlave,

Quinones

et al. 2024

JAMA Health Forum

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ImportanceThe 340B program provides discounts on outpatient drugs to certain hospitals and federally supported clinics (covered entities) that can be used to generate revenue to fund safety net care. While numerous studies have found no association between 340B and safety net care provision for most hospital covered entities, less is known about whether federally qualified health centers (FQHCs), the largest group of covered entities after hospitals, use the program to enhance safety net care.ObjectiveTo assess whether a proxy for 340B revenue was associated with increased safety net care provision among FQHCs.Design and SettingThis descriptive, retrospective cohort study examined care provided from 2005 to 2022 by 1468 FQHCs that submitted to the Health Resources and Services Administration Uniform Data System. FQHC and year-level fixed effects were included, as well as a control for differential Medicaid expansion over time. The data were analyzed between March and December 2023.ExposureOne-year lagged number of locations registered to dispense or administer 340B-discounted drugs (registered locations), which included child sites, in-house pharmacies, and contract pharmacies in the 340B Outpatient Pharmacy Affairs Database.Main outcomesNatural logarithm of patient volume by payer, low-income status, and use of enabling services. Natural logarithm of visits in which low-profit preventive services were provided.ResultsAn additional registered location was associated with increased patient volume, especially for uninsured (0.4%; 95% CI, 0.3%-0.5%) and privately insured (0.4%; 95% CI, 0.2%-0.5%) patients and low-income (0.4%; 95% CI, 0.2%-0.6%), unhoused (0.3%; 95% CI, 0.1%-0.5%), and non–English-speaking (0.3%; 95% CI, 0.1%-0.5%) patients. An additional registered location was associated with increased visits with an HIV test (0.7%; 95% CI, 0.4%-0.9%), serum lead test (0.8%; 95% CI, 0.6%-1.1%), seasonal influenza shot (0.4%; 95% CI, 0.3%-0.5%), Papanicolaou smear (0.5%; 95% CI, 0.4%-0.7%), and tobacco cessation counseling (1.0%; 95% CI, 0.5%-1.4%). Across the study period, the average annual increase in locations was 1.5.Conclusions and RelevanceThe results of this cohort study suggest that there are statistically significant increases in the provision of low-profit but high-value preventive services and care to safety net populations (those who lack insurance, have a low income, or require enabling services) and that, like public hospitals, FQHCs might use 340B revenues to enhance safety net care. This finding may inform debates on the 340B program by supporting differential 340B reforms across hospital and nonhospital covered entities.

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Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers

Cited by 40 publications

References 21 publications

Community pharmacist-led clinical services: physician's understanding, perceptions and readiness to collaborate in a Midwestern state in the United States†

Community pharmacist-led clinical services: physician's understanding, perceptions and readiness to collaborate in a Midwestern state in the United States†

Preparing for pharmacist prescribing in Maltese hospitals

340B Participation and Safety Net Engagement Among Federally Qualified Health Centers

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