The Mississippi Delta Health Collaborative Medication Therapy Management Model: Public Health and Pharmacy Working Together to Improve Population Health in the Mississippi Delta

Abstract

What is known on this topic? The Mississippi Delta has high rates of chronic disease and is known for its poor health outcomes and health disparities. Medication therapy management (MTM) improves the safe and effective use of medications, and ensuring appropriate medication use can improve clinical outcomes related to cardiovascular disease (CVD). What does this research add to the literature? Pharmacists met face-to-face in federally qualified health centers with patients who had a diagnosis of diabetes, hypertension, and/or dyslipidemia to provide MTM. Patients experienced mean reductions in systolic and diastolic blood pressure, low-density lipoprotein cholesterol, triglycerides, total cholesterol, and hemoglobin A 1c. What are the implications for public health practice? MTM is an effective way to improve CVD outcomes in residents of regions like the Mississippi Delta that have high rates of poverty, health disparities, and poor health outcomes.

Impact of pharmacist‐led chronic disease management in a Federally Qualified Health Center

“…23 Other studies which have assessed the impact of medication management by pharmacists in FQHCs have demonstrated that pharmacist management can significantly improve A1C control. [11][12][13][14][15] The magnitude of A1C percentage point change seen in this study appears comparable to that seen in similar studies. [11][12][13][14][15] When considering hypertension, the mean SBP at baseline was consistent with Grade 2 hypertension, and at the end of the study, the mean SBP was reduced to Grade 1 hypertension and met the essential hypertension goal as defined by the 2020 International Society of Hypertension Global Hypertension Practice Guidelines.…”

“…10 Much of the available literature describing pharmacist services within FQHCs focuses on the management of diabetes mellitus and associated cardiovascular disease and results indicate that when pharmacists are added to the healthcare team, clinical outcome measures such as glycated hemoglobin (A1C), blood pressure, and cholesterol levels improve. [11][12][13][14][15][16][17] Such studies are of variable quality and include limitations such as being retrospective, lacking comparison groups, being descriptive in nature without statistical analyses, focusing on only one disease state, and/or including a small number of patients. [11][12][13][14][15][16][17] As such, there is an ongoing need to provide additional evidence which describes the provision of CDM services by pharmacists to further define the ways in which they can impact care in the FQHC setting.…”

“…[11][12][13][14][15][16][17] Such studies are of variable quality and include limitations such as being retrospective, lacking comparison groups, being descriptive in nature without statistical analyses, focusing on only one disease state, and/or including a small number of patients. [11][12][13][14][15][16][17] As such, there is an ongoing need to provide additional evidence which describes the provision of CDM services by pharmacists to further define the ways in which they can impact care in the FQHC setting. Henry J. Austin Health Center (HJAHC), an FQHC in Trenton, NJ, is a system of 8 sites and one mobile health unit that provides care to over 18 000 patients throughout Mercer County.…”

Pharmacist care in Federally Qualified Health Centers: A narrative review

“…10 Aligned with the core principles of the FQHC model, multiple studies cited partnerships between FQHCs and state health departments and/or academic institutions to provide enhanced diabetes and hypertension screening, linkages to care, and comprehensive, interprofessional care to improve achievement of quality metrics for these chronic diseases. [13][14][15] Many studies described integrated care models that involved collaborative practice agreements (CPAs), such as in FQHCs in Arizona, 16 Ohio, 14 and California. 17 One study demonstrated the impact of pharmacists as part of interdisciplinary care teams operating under CPAs whereby pharmacists helped lower A1c by 1.6% on average, compared with 0.9% with physician-only care.…”

Impact of remote delivery of clinical pharmacy services on health disparities and access to care

“…perspective, clinical pharmacy services have benefits that can lower overall health care expenses. Many examples show the impact of clinical pharmacist services on improving clinical outcomes specifically in underserved populations [87][88][89][90][91]. Considering both the clinical benefit and the cost-effectiveness of clinical pharmacy services, it is necessary to continue to advocate for reimbursement of remote pharmacist-delivered services 92.…”