The impact of clinical pharmacist led comprehensive medication management on diabetes care at Federally Qualified Health Centers within the BD Helping Build Healthy Communities program

Abstract

Introduction:The BD Helping Build Healthy Communities (HBHC) program is a philanthropically funded initiative designed to provide support for comprehensive medication management (CMM) services at Federally Qualified Health Centers (FQHCs) to support care for low-income populations.Objectives: The primary outcome of interest was the change in glycosylated hemoglobin (HbA1c) between baseline and 6 months with changes in systolic (SBP) and diastolic blood pressure (DBP) between baseline and 6 months being evaluated as secondary outcomes.Methods: Awardees of the HBHC program who provided clinical pharmacist led CMM services in 2017, 2018, or 2019 to address the needs of people living with diabetes, were asked to complete a standardized monitoring template to evaluate their progress in serving patients receiving care at their clinic. The data from these reports was then analyzed using the paired t test to identify statistically significant changes in HbA1c, SBP, and DBP.Results: A total of eight FQHCs, providing care to a total of 2502 patients, received funding within the HBHC program for their CMM activities related to diabetes.Within the primary outcome analysis of the change in HbA1c at 6 months, a statistically significant reduction in average clinic HbA1c between baseline and 6 months (9.4 vs 8.2, mean difference 1.2, 95% CI [0.45-1.97, P <.01]) was observed. Similarly, a statistically significant reduction was observed between baseline and 6 months for

Expanding comprehensive medication management considerations to include responses to the social determinants of health within the BDHelping Build Healthy Communities Program

“…Their support has been used to create the BD Helping Build Healthy Communities (HBHC) program (https://www.directrelief.org/work/bdhbhc/) which has provided over $5.8 million in grants to support 39 FQHC programs across America. In a recently completed retrospective analysis of grant awardees for the years 2017 to 2019, statistically significant reductions in glycosylated hemoglobin (HbA1c) were observed across nine clinics which served 2502 patients 18 . While there has been considerable success from HBHC's past investments in MTM/CMM, previous and current FQHC partners have been mentioning how they have used the flexible funding provided through HBHC to pilot novel initiatives which allow clinical pharmacists to incorporate considerations for the broader needs of their patients beyond clinical care 18 .…”

“…In a recently completed retrospective analysis of grant awardees for the years 2017 to 2019, statistically significant reductions in glycosylated hemoglobin (HbA1c) were observed across nine clinics which served 2502 patients 18 . While there has been considerable success from HBHC's past investments in MTM/CMM, previous and current FQHC partners have been mentioning how they have used the flexible funding provided through HBHC to pilot novel initiatives which allow clinical pharmacists to incorporate considerations for the broader needs of their patients beyond clinical care 18 . This effort has been supported by the integration of clinical pharmacy activities across multiple different disciplines within FQHC's making clinical pharmacists uniquely positioned to connect different services which may positively impact the overall health of patients, particularly those with chronic health needs.…”

“…18 While there has been considerable success from HBHC's past investments in MTM/CMM, previous and current FQHC partners have been mentioning how they have used the flexible funding provided through HBHC to pilot novel initiatives which allow clinical pharmacists to incorporate considerations for the broader needs of their patients beyond clinical care. 18 This effort has been supported by the integration of clinical pharmacy activities across multiple different disciplines within FQHC's making clinical pharmacists uniquely positioned to connect different services which may positively impact the overall health of patients, particularly those with chronic health needs. The interconnectedness of pharmacist services makes them an underutilized aspect of the healthcare system as healthcare funding agencies continue to shift to valuebased care payment models which tend to prioritize the quality of services delivered as opposed to the quantity of services.…”

Comparison of clinical pharmacist visits based on language preference in an urban underserved clinic: A cross‐sectional analysis

“…1 Clinical pharmacists have demonstrated improved outcomes for patients in low resource centers with vulnerable populations, such as federally qualified health centers 2 and for patients with low health literacy. 3 Comprehensive Medication Management services are highly valued by members of the clinical team, with physicians reporting high levels of satisfaction and positive impacts on quality of care, 4 as well as improvement in numerous disease outcomes, including diabetes, [5][6][7] hypertension, 6,7 and mental health. 8 Persons who prefer a language other than English, termed Non-English Language Preferred (NELP), are one such group with potential to benefit from CMM services.…”