Reaching the Hard-to-Reach: Outcomes of the Severe Hypertension Outreach Intervention

Biola, Holly; Deyo, Jennifer; Hayes, Tiffany; Small, Linda; Chaplin, Joan; Pak-Harvey, Ezra; Granger, Thomas; Jung, Lynne; Fitzgerald, Lynn; Crowder, Carolyn; Patel, Bina; Stillwell, Tracy; Eisenson, Howard; Granger, Bradi B.

doi:10.1016/j.amepre.2020.05.030

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…The value of team-based interventions for implementing existing evidence-based strategies for reducing BP in high-risk populations was further supported in this project. 24 Overall, multidisciplinary team-based interventions that include improving patient access to educational information, skills for use of BP cuffs and selfmonitoring, and use of pharmacists to optimize medications allow patients a greater opportunity for successful reduction of uncontrolled BP.…”

Section: Discussionmentioning

confidence: 99%

Improving Hypertension Control in the Black Patient Population

Duckie,

Boston,

Champagne

et al. 2023

Journal of Nursing Care Quality

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Background: Nearly half of American adults have hypertension (HTN), and non-Hispanic Black patients are diagnosed at a higher rate than others. Local Problem: Our local clinic population reflected disproportionate rates of uncontrolled HTN among Black patients. Methods: A quality improvement pre-/postintervention design was used to evaluate an educational intervention to reduce blood pressure (BP) and improve self-monitoring of BP in Black patients using the Chronic Care Model. Interventions: A team-based approach was used to redesign clinic workflows and patient education, prescribe self-paced videos from an electronic health record (EHR) patient portal, and provide home BP cuffs. Results: Black participants (n = 79) improved viewing of prescribed videos (7.9% to 68.5%), knowledge scores (67.9 to 75.2), and mean systolic BP (−20.3 mm Hg; P > .001). Conclusions: This team-based approach enhanced patient engagement, self-monitoring skills, EHR-reported BP, and overall BP control for a cohort of Black patients with uncontrolled BP.

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Section: Discussionmentioning

confidence: 99%

Improving Hypertension Control in the Black Patient Population

Duckie,

Boston,

Champagne

et al. 2023

Journal of Nursing Care Quality

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“…This study received university-level approval from the Internal Review Board and was conducted in a Federally Quali ed Health Center (FQHC) located in the southeastern region of the U.S. FQHCs serve lower income patients who are often conceptualized as hard to reach 23 . Sampling patients within an FQHC therefore provides added context as these populations are often not included within research on discrimination and its health in uences 24 .…”

Section: Methodsmentioning

confidence: 99%

Analyzing the mediating effects between discrimination and depression: A cross-sectional study

Cooper¹,

Pitner

Ali

2023

Preprint

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Background Depression is pervasive and influences health. There is, however, a lack of understanding regarding the nuanced way racial discrimination influences depression within medical settings. Objective To increase understanding regarding the relationship between discrimination and depression, we analyzed the relationships between experiencing discrimination and depressive symptoms, whether anxiety and stress were mediators of this relationship, and whether self-esteem and racial identity moderated these relationships. Design: Stratified random sampling was used to identify 383 participants (228 White and 155 Black). Hayes’ PROCESS macro was utilized to analyze both the mediating and moderating influences of discrimination on depression. Results The overall model showed that discrimination, self-esteem, racial identity, anxiety, and perceived stress accounted for 57% of the variance in depressive symptoms. There was a significant direct association between experiences of discrimination with depressive symptoms (B = .21, p > .01). Both anxiety (B = .24, p < .01) and perceived stress (B = .53, P < .01) were also associated with depressive symptoms. Self- Esteem appeared to moderate the relationship between discrimination and both anxiety (B = − .60, P < .01) and perceived stress (B = − .55, p < .01). Conclusions These data suggest that, in the presence of depressive symptoms, clinicians should consider screening for discrimination, stress, and anxiety. In addition, interventions emphasizing self-esteem may mitigate the influence of discrimination, stress, and anxiety.

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“…Targeted approaches to enhancing adherence to medications for the management of diabetes and hypertension have also been published. One article discussed an embedded 340B pharmacy within an FQHC that enhanced the pharmacy's inventory with combination products to treat hypertension and then conducted focused adherence counseling with notes integrated in the electronic health record (EHR) to facilitate patient access and consistent use of medications, as well as foster cohesion across the spectrum of care 19 . In another example, to increase access to medication and care for rural patients, an FQHC developed a partnership with a community pharmacy located 50 miles away where the pharmacist with a CPA conducted medication reconciliation, assessed medication adherence and the patient's lifestyle and medications, and adjusted and/or initiated blood pressure medications 20…”

Section: Pharmacist‐provided Care In Fqhcsmentioning

confidence: 99%

Pharmacist care in Federally Qualified Health Centers: A narrative review

Rodis

Irwin

Valentino

et al. 2022

J Am Coll Clin Pharm

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Federally Qualified Health Centers (FQHCs) are critical to providing care to underserved populations in the United States. Their focus on interprofessional care has also made FQHCs ideal locations to integrate pharmacists into care teams and advance pharmacy practice. However, despite long-standing involvement by pharmacists, there have been limited attempts to synthesize this literature. We conducted a comprehensive search for published literature on the roles of pharmacists in FQHCs and narrowed our search to 54 manuscripts and abstracts for inclusion in this narrative review. We found that pharmacists in FQHCs are providing care that is interprofessional, multifaceted, and evolving rapidly in response to environmental changes.Pharmacists are routinely involved in the traditional management of chronic disease, such as diabetes, hypertension, behavioral health, and respiratory conditions. In addition, pharmacists have forged roles in preventive care, infectious disease, and pain management. Models include appointment-based approaches; however, there was also heterogeneity in approaches consistent with the dynamic nature of the healthcare system in the United States with engagement in population health, transitions of care, and telehealth, as a few examples. Collaborative practice agreements were used to deliver care in some cases, although this was not commonplace, and reimbursement by third party payers was rarely addressed. Relationships with community pharmacies, often driven by the 340B Drug Pricing Program, were also noted.Recommendations for future research in this area include increasing the rigor of future research by standardizing pharmacy interventions and including comparator groups, a greater focus on financial sustainability, and further exploration of how state laws surrounding pharmacist provider status and scope of practice impact pharmacy service development.

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Reaching the Hard-to-Reach: Outcomes of the Severe Hypertension Outreach Intervention

Cited by 8 publications

References 16 publications

Improving Hypertension Control in the Black Patient Population

Improving Hypertension Control in the Black Patient Population

Analyzing the mediating effects between discrimination and depression: A cross-sectional study

Pharmacist care in Federally Qualified Health Centers: A narrative review

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