IntroductionPharmacists are underused in the care of chronic disease. The primary objectives of this project were to 1) describe the factors that influence initiation of and sustainability for pharmacist-provided medication therapy management (MTM) in federally qualified health centers (FQHCs), with secondary objectives to report the number of patients receiving MTM by a pharmacist who achieve 2) hemoglobin A1c (HbA1c) control (≤9%) and 3) blood pressure control (<140/90 mm Hg).MethodsWe evaluated MTM provided by pharmacists in 10 FQHCs in Ohio through qualitative thematic analysis of semi-structured interviews with pharmacists and FQHC leadership and aggregate reporting of clinical markers.ResultsFacilitators of MTM included relationship building with clinicians, staff, and patients; regular verbal or electronic communication with care team members; and alignment with quality goals. Common MTM model elements included MTM provided distinct from dispensing medications, clinician referrals, and electronic health record access. Financial compensation strategies were inadequate and varied; they included 340B revenue, incident-to billing, grants, and shared positions with academic institutions. Of 1,692 enrolled patients, 60% (n = 693 of 1,153) achieved HbA1c ≤9%, and 79% (n = 758 of 959) achieved blood pressure <140/90 mm Hg.ConclusionThrough this statewide collaborative, access for patients in FQHCs to MTM by pharmacists increased. The factors we identified that facilitate MTM practice models can be used to enhance the models to achieve clinical goals. Collaboration among clinic staff and community partners can improve models of care and improve chronic disease outcomes.
The purpose of this study is to examine the issues Hmong immigrants considered family secrets and to whom they would disclose their secrets when these secrets became problematic to them. Ninety-nine Hmong immigrant adults (39 males and 60 females), with ages ranging from 18 to 89 participated in this study. Content analysis found more than half of the participants considered marital issues to be secrets, while descriptive statistics found spousal arguments about family chores were the most secretive, followed by arguments about children, and overspending. Relatives on the husband's side, spouse, family members, and adult children were among the most frequent recipients of disclosures. The article concluded with some suggestions for educators, practitioners, and policymakers who work with Hmong immigrant families.
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