Population health management: An independent physician organization approach

Altavela, Jeanette L.; Dorward, Kathryn M.; Sorrento, Thomas A.; Diehl, Katherine M.; Wyman, Cori A.

doi:10.2146/ajhp161009

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…The important role of intestinal FGF15/19 in regulating bile acid production and cholesterol levels highlights the potential for this gut/liver signaling to regulate multiple aspects of liver function that may contribute to disease. MASLD affects up to 25% of the world population and is one of the most prevalent liver diseases ( 45 ). MASLD presents with varying phenotypic stages ranging from steatosis to MASH, fibrosis, cirrhosis, and liver carcinoma ( 45 ).…”

Section: Discussionmentioning

confidence: 99%

“…MASLD affects up to 25% of the world population and is one of the most prevalent liver diseases ( 45 ). MASLD presents with varying phenotypic stages ranging from steatosis to MASH, fibrosis, cirrhosis, and liver carcinoma ( 45 ). MASLD and MASH have emerged as leading causes of chronic liver disease that represent a global health challenge.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal FGF15 regulates bile acid and cholesterol metabolism but not glucose and energy balance

Bozadjieva-Kramer,

Shin,

et al. 2024

JCI Insight

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Fibroblast growth factor 15/19 (FGF15/19, mouse/human ortholog) is expressed in the ileal enterocytes of the small intestine and released postprandially in response to bile acid absorption. Previous reports of FGF15 –/– mice have limited our understanding of gut-specific FGF15’s role in metabolism. Therefore, we studied the role of endogenous gut-derived FGF15 in bile acid, cholesterol, glucose, and energy balance. We found that circulating levels of FGF19 were reduced in individuals with obesity and comorbidities, such as type 2 diabetes and metabolic dysfunction–associated fatty liver disease. Gene expression analysis of ileal FGF15-positive cells revealed differential expression during the obesogenic state. We fed standard chow or a high-fat metabolic dysfunction-associated steatohepatitis–inducing diet to control and intestine-derived FGF15-knockout (FGF15 INT-KO ) mice. Control and FGF15 INT-KO mice gained similar body weight and adiposity and did not show genotype-specific differences in glucose, mixed meal, pyruvate, and glycerol tolerance. FGF15 INT-KO mice had increased systemic bile acid levels but decreased cholesterol levels, pointing to a primary role for gut-derived FGF15 in regulating bile acid and cholesterol metabolism when exposed to obesogenic diet. These studies show that intestinal FGF15 plays a specific role in bile acid and cholesterol metabolism regulation but is not essential for energy and glucose balance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intestinal FGF15 regulates bile acid and cholesterol metabolism but not glucose and energy balance

Bozadjieva-Kramer,

Shin,

et al. 2024

JCI Insight

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“…1 Improved medication use, achieved through the delivery of comprehensive medication management (CMM) by pharmacists, 2,3 has been shown to lead to patient satisfaction and trust, reduced medical costs, and improvement in population health. [4][5][6] Thus, pharmacists serve an integral role within the interdisciplinary team to deliver high quality and value health care.…”

Section: What This Study Addsmentioning

confidence: 99%

Development of measurable criteria to identify and prioritize patients for inclusion in comprehensive medication management programs within primary care settings

Bishop

Chang

Kitchen

et al. 2021

JMCP

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BACKGROUND: Pharmacists optimize medication use and ensure the safe and effective delivery of pharmacotherapy to patients using comprehensive medication management (CMM). Identifying and prioritizing individual patients who will most likely benefit from CMM can be challenging.Health systems have far more candidates for CMM than there are clinical pharmacists to provide this service. Furthermore, current evidence lacks widely accepted standards or automated mechanisms for identifying patients who would likely benefit from a pharmacist consultation. Existing tools to prioritize patients for pharmacist review often require manual chart review by a pharmacist or other clinicians or data collection by patient survey. What is already known about this subject• Medication use is nearly universal, and pharmacists can improve the safety and efficacy of medication use through comprehensive medication management (CMM).

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“…For example, Altavela et al created a practice model focusing on complex and resource intensive patients, and clinical pharmacist involvement demonstrated a 42% decrease in 30-day readmission rates and a 20% decrease in annual medical charges. 4 Carmichael and colleagues utilized electronic health record (EHR) data within the Veterans Health Administration (VHA) to identify patients failing to meet healthcare effectiveness data and information set (HEDIS) measures. 5 Data gathered from the EHR was compiled into an interactive “dashboard” which allowed clinical pharmacists to proactively contact applicable patients resulting in over 5,000 additional screenings of patients for hepatitis C virus (HCV), as well as a 5% increase in timely hemoglobin A1c measurements in patients at risk for hypoglycemia.…”

Section: Introductionmentioning

confidence: 99%

Population Health Management during Student Pharmacist Introductory Experiential Education to Expand Clinical Pharmacist Impact

et al. 2019

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Objective: To evaluate the impact of incorporating pre-advanced pharmacy practice experience (pre-APPE) student pharmacists into three different population health management (PHM) projects. Methods: The prospective quality improvement projects incorporated three third-year student pharmacists who developed and conducted individual PHM projects over the course of three to seven months. The projects included hypoglycemia screening, hepatitis C virus and human immunodeficiency virus screening, and statin use evaluations for atherosclerotic cardiovascular disease risk reduction. Under the guidance of a clinical pharmacist, students developed project materials, conducted patient chart reviews, and contacted patients to make interventions such as recommendations for therapy, ambulatory patient monitoring, patient education, and arranging provider follow-up. Student impact was evaluated through the number of patients screened, the number of eligible patients contacted, and the total number of interventions or recommendations made. Student time spent was tracked throughout the projects. Results: Out of 244 patients screened, 198 patients met inclusion criteria and 162 patients were contacted or assessed by a student pharmacist. Students made a total of 319 interventions, including patient education (132), patient monitoring (132), pharmacotherapy recommendations (28), and arranging follow-up (27). On average students screened 33 patients per month, and, per patient, required 8.6 minutes for eligibility assessment and approximately 6 minutes for telephone interviews. Conclusion: This report demonstrates that pre-APPE student pharmacists are well-equipped to design and implement PHM projects. Utilization of student pharmacists in similar PHM programs can expand the pharmacist’s impact on patient care in the ambulatory care setting. Article Type: Original Research

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Population health management: An independent physician organization approach

Abstract: As part of a multidisciplinary team, clinical pharmacists are able to optimize medication use and engage patients and physicians to reduce medical and medication costs for contracted patients.

Cited by 4 publications

References 14 publications

Intestinal FGF15 regulates bile acid and cholesterol metabolism but not glucose and energy balance

Intestinal FGF15 regulates bile acid and cholesterol metabolism but not glucose and energy balance

Development of measurable criteria to identify and prioritize patients for inclusion in comprehensive medication management programs within primary care settings

Population Health Management during Student Pharmacist Introductory Experiential Education to Expand Clinical Pharmacist Impact

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