Pharmacists and community health workers improve medication-related process outcomes among Cambodian Americans with depression and risk for diabetes

Polomoff, Christina M.; Bermúdez‐Millán, Angela; Buckley, Thomas; Buxton, Orfeu M.; Feinn, Richard; Kong, Sengly; Kuoch, Theanvy; Lim, Mackenzie; Scully, Mary; Wagner, Julie

doi:10.1016/j.japh.2021.10.031

Cited by 9 publications

(6 citation statements)

References 45 publications

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“…Mean drug therapy problems per participant in the MTM arm at baseline was 6.6 (SD = 4.3) 13 . The most frequent type of drug therapy problem was safety (M = 2.6, SD = 2.8) and the least frequent type was effectiveness (M = 0.7, SD = 0.9).…”

Section: Resultsmentioning

confidence: 99%

“…Nearly 84% of all drug therapy problems were resolved, ranging from 74% resolution for effectiveness to 94% resolution for adherence. Most (88%) were resolved by the CHW-pharmacist team without intervention from the prescriber 13 .…”

Section: Resultsmentioning

confidence: 99%

“…Cambodian Americans may receive medication for their health needs, but barriers related to language, finances, and very low educational attainment may create drug therapy problems with polypharmacy, drug safety, appropriateness, effectiveness, and adherence 12 . Medication therapy management (MTM) is a pharmacist intervention designed to resolve drug therapy problems 13 ; MTM is not designed to test any particular medication.…”

Section: Introductionmentioning

confidence: 99%

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Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Wagner

Bermúdez‐Millán

Buckley

et al. 2023

Sci Rep

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Depression and antidepressant medications increase risk for type 2 diabetes. Cambodian-Americans have exceedingly high rates of both depression and diabetes. This paper reports outcomes of a diabetes prevention trial for Cambodian-Americans with depression. Primary outcomes were HbA1c, insulin resistance and depressive symptoms. Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either (a) antidepressant medication and/or (b) prolonged elevated depressive symptoms. Participants were randomized to one of three community health worker (CHW) interventions: (1) lifestyle intervention called Eat, Walk, Sleep (EWS), (2) EWS plus medication therapy management sessions with a pharmacist/CHW team to resolve drug therapy problems (EWS + MTM), or, (3) social services (SS; control). Assessments were at baseline, post-treatment (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal educational attainment was 7.0 years. Compared to the other arms, EWS + MTM showed a significant decrease in HbA1c and a trend for reduced inflammation and stress hormones. Depressive symptoms improved for EWS and EWS + MTM relative to SS. There was no change in insulin resistance. Cardiometabolic and mental health can be improved in tandem among immigrant and refugee groups.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Wagner

Bermúdez‐Millán

Buckley

et al. 2023

Sci Rep

Self Cite

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“…Secondary data analysis was conducted on baseline assessments from a diabetes prevention trial for Cambodian Americans with depression, the Diabetes Risk Reduction through Eat, Walk, Sleep and Medication Therapy Management (DREAM) trial (Wagner et al, 2021 ), clinicaltrials.gov identifier NCT02502929. Previously published articles provide details of the methods and a CONSORT diagram (Polomoff et al, 2021 ; Wagner et al, 2021 ). The data reported here are from baseline assessments only and solely for those participants who were randomized to receive MTM intervention and therefore completed a DTP review.…”

Section: Methodsmentioning

confidence: 99%

“…CHWs met with participants to complete a medication review form. Their training to decrease bias during survey administration and MTM has been previously described (Polomoff et al, 2021 ; Wagner et al, 2021 ). Training the CHWs included shadowing expert pharmacists complete the medication review form, sessions with our pharmacist investigator and the bilingual study coordinator totaling 4 h, and role play with illustrative case examples.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for drug therapy problems among Cambodian Americans with complex needs: a cross-sectional, observational study

Wagner

Bermúdez‐Millán

Berthold

et al. 2022

Health Psychology and Behavioral Medicine

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Background Pharmaceutical drug therapy problems (DTPs) are a major public health problem. We examined patient-level risk factors for DTPs among Cambodian Americans. Methods Community health workers (CHWs) verbally administered surveys and completed a detailed medication review form with participants. A doctoral-level pharmacist reviewed the form with the patient and CHW to determine DTP number and type (appropriateness, effectiveness, safety, and adherence). Results Participants ( n = 63) averaged 55 years old, 6 years of education, 52% were married, 87% spoke Khmer at home, with modal household income <$20,000 (41%). The percentage of participants with DTPs was: 45% appropriateness, 25% effectiveness, 64% safety, and 30% adherence, averaging 3.7 DTPs per patient. In multiple regressions, patient characteristics uniquely predicted each type of DTP. In a multiple regression controlling for number of medications, being married reduced total DTPs (IRR = 0.70) and being depressed increased total DTPs (IRR = 1.26). Conclusions Vulnerable patients should be prioritized for pharmacist/CHW teams to identify DTPs. Trial registration:

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The evolving role of pharmacists in depression care: a scoping review

Shalash,

Zolezzi

2024

Int J Clin Pharm

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Background Worldwide, depression is known to contribute significantly to the global burden of disease. Considering pharmacists are among the most approachable healthcare providers, they are well-placed to assist people with depression achieve positive treatment outcomes. Aim The primary aim was to examine the evidence regarding pharmacists’ roles in interventions, outcomes, and barriers to implementation within depression care globally, with the secondary aim focusing on the Arab region. Method A scoping review was conducted according to the PRISMA-ScR extension guidelines and the Joanna Briggs Institute framework, using Scopus, Cochrane, ProQuest, and Medline databases for studies worldwide and within the Arab region (22 Arab-league countries). Article selection, along with data extraction, analysis, and narrative synthesis were performed independently by two reviewers. Discrepancies were resolved by consensus. Results Forty studies reporting various roles and services provided by pharmacists in depression management were included. Most articles (24) described studies on pharmacist-led specific/single interventions/management strategies, and 16 described studies in which pharmacists provided comprehensive or team-based services. The majority of studies reported positive impact on patient outcomes. In accordance with the secondary aim, only three studies assessed various pharmacists’ services for people with depression in the Arab region. Barriers to effective depression-related care included time constraints and training needs. Conclusion This scoping review supports the expanding role of pharmacists in depression management. The interventions, impact, challenges, and research gaps identified serve as preliminary evidence for advocating for an expanded pharmacists’ scope of practice in mental health, both globally and in the Arab region.

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Pharmacists and community health workers improve medication-related process outcomes among Cambodian Americans with depression and risk for diabetes

Cited by 9 publications

References 45 publications

Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Risk factors for drug therapy problems among Cambodian Americans with complex needs: a cross-sectional, observational study

The evolving role of pharmacists in depression care: a scoping review

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