Clinical pharmacist team-based care in a safety net medical home: facilitators and barriers to chronic care management

Price-Haywood, Eboni G., Amering, Sarah, Luo, Qingyang and Lefante, John J. (2017) Clinical pharmacist team-based care in a safety net medical home: facilitators and barriers to chronic care management. Population Health Management, 20 2: 123-131. doi:10.1089/pop.2015.0177


Author Price-Haywood, Eboni G.
Amering, Sarah
Luo, Qingyang
Lefante, John J.
Title Clinical pharmacist team-based care in a safety net medical home: facilitators and barriers to chronic care management
Journal name Population Health Management   Check publisher's open access policy
ISSN 1942-7905
1942-7891
Publication date 2017-04-01
Sub-type Article (original research)
DOI 10.1089/pop.2015.0177
Open Access Status Not yet assessed
Volume 20
Issue 2
Start page 123
End page 131
Total pages 9
Place of publication New Rochelle, NY, United States
Publisher Mary Ann Liebert
Language eng
Subject 2911 Leadership and Management
2719 Health Policy
2739 Public Health, Environmental and Occupational Health
Abstract Collaborative care models incorporating pharmacists have been shown to improve quality of care for patients with hypertension and/or diabetes. Little is known about how to integrate such services outside of clinical trials. The authors implemented a 22-month observational study to evaluate pharmacy collaborative care for hypertension and diabetes in a safety net medical home that incorporated population risk stratification, clinical decision support, and medication dose adjustment protocols. Patients in the pharmacy group saw their primary care provider (PCP) more often and had higher baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) and A1c levels compared to patients who only received care from their PCPs. There were no significant differences in the proportion of patients achieving treatment goals (SBP <140, DBP <90; A1c < 8) or the magnitude of change in BP or A1c among patients who underwent collaborative care versus those who did not. Age, race, and number of PCP encounters were associated with BP and A1c trends. The median time to achieve disease control was longer in the pharmacy group. Although 70% of all patients with poorly controlled hypertension achieved treatment goals within 7 months, less than 50% of patients with poorly controlled diabetes achieved A1c < 8 within 15 months, suggesting that diabetes was harder to manage overall. Contextual factors that facilitated or hindered practice redesign included organizational culture, health information technology and related workflows, and pharmacy caseload optimization. Future studies should further examine implementation strategies that work best in specific settings to optimize the benefits of team-based care with clinical pharmacists.
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID U54 GM104940
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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