Collaborative focuses on improving health
of diabetics in the Delta
Pharmacist Laurie Warrington
counsels a patient at the G.A. Carmichael Family Health Center in Yazoo
City.
iabetes is more prevalent and
causes more deaths in the Mississippi Delta than anywhere else in the
nation. To make matters worse, many of the area’s diabetic patients
lack access to health care, don’t understand their complex medication
regimens and can’t afford them.
In response to the epidemic, the School of
Pharmacy is providing medication therapy management services and
disease-specific education for the region’s high-risk diabetes patients
through the Health Resources and Services Administration Patient Safety
and Clinical Pharmacy Services Collaborative.
Funded by HRSA, the PSPC collaborative is a
national effort to transform health care by teaching teams of providers
practical steps to integrating clinical pharmacy services into the
primary health care home of patient populations with poor health status
and high medication risk. More than 100 teams across the country are
participating in the collaborative, which is beginning its third year.
Through this collaborative, the pharmacy school is
partnered with the G.A. Carmichael Family Health Center in Yazoo City
and the Delta Health Alliance 21st Century Good Samaritan Health Center
in Greenville. The school is also working with the Family Health Center
in Laurel.
The school’s work in Yazoo City and Greenville
received three national awards in October, when teams from around the
country gathered in Dallas to kick off the collaborative’s third year.
The Health Outcome Management Award and the Clinical Pharmacy Services
Improvement Award were earned by the team working at the G.A.
Carmichael clinic, and the Outstanding Performance Award went to the
team at the Good Samaritan clinic.
‘In addition to appropriate medication use, we
address lifestyle issues such as diet, exercise, psychological concerns
and education.’
Lorelei Farr
“At these sites, pharmacists are enrolling 25
patients with uncontrolled diabetes,” said Lauren S. Bloodworth,
clinical assistant professor and program administrator. “After an
initial face-to-face consultation, patients have one-on-one follow-up
visits with the pharmacist on an as-needed basis.”
The collaborative’s main focus is improving the
health and well-being of high-risk diabetes patients, and this is best
achieved when they are made responsible for their own health outcomes,
Bloodworth said. “We help them set their own health care goals. If
short-term goals have been met, we help them add new targets. If goals
are not met, we discuss what was difficult to achieve and develop a new
plan to improve their health care status.”
Managing patients with uncontrolled diabetes can
be complex. Pharmacists begin by reviewing all prescription and
nonprescription medications, herbal products and dietary supplements
patients are taking. After assessing the presence of any
medication-related problems, pharmacists work with patients, physicians
or other health care professionals to resolve them.
“In addition to appropriate medication use, we
address lifestyle issues such as diet, exercise, psychological concerns
and education,” said Lorelei Farr, a UM pharmacist who helps care for
patients in Yazoo City. “We also measure key health indicators such as
hemoglobin A1c, blood pressure, BMI (Body Mass Index) and lipid levels,
as well as adherence to medication regimens by tracking pharmacy refill
records and recommendations made to each patient’s providers.”
The PSPC is part of a larger School of Pharmacy
effort in the Delta region, the Delta Pharmacy Patient Care Management
Project. Since the project began in July 2008, faculty members visited
participating community pharmacies in Batesville, Clarksdale and Yazoo
City, providing Medicaid patients with medication therapy management
services and education related to asthma and diabetes.
Last year, the project expanded to include more
Delta counties and patients beyond Medicaid recipients. Generalized
medication therapy management and health-literacy and
cultural-competency components were added, and a new community pharmacy
residency program was created.
This year, the program’s third, services are being
provided in 13 pharmacies in nine counties. The project is expanding to
address the important health challenge of obesity and will be adding an
employer-based prevention and diabetes management program, said Leigh
Ann Ross, associate dean and chair of pharmacy practice.
“We will continue the existing therapy management
arm, which is aimed at achieving outcomes through the effective use of
medications, patient education and the prevention of drug complications
or interactions,” Ross said. “It’s a more comprehensive approach to
patient care. Plus, we will focus on further developing clinical
pharmacy services by placing pharmacists in clinic settings to
participate as part of the patient’s primary health care team.”
The Delta Pharmacy Patient Care Management Project
provides a structure for that care, which is particularly important in
rural areas, and the PSPC provides a platform for integrating pharmacy
services.
With many of its faculty members on the UM Medical
Center campus, the Department of Pharmacy Practice leads the Delta
project in collaboration with the Department of Pharmacy Administration
and the Center for Pharmaceutical Marketing and Management.
The Delta Pharmacy Patient Care Management Project
is funded by the Health Resources and Services Administration through
the nonprofit Delta Health Alliance, which funds several projects aimed
at coordinating health efforts in the region.
“The awards received in Dallas speak to the
quality and importance of the work our teams are doing in the PSPC
project,” said pharmacy school dean Barbara G. Wells. “It’s always nice
to be recognized for the important work that we do, especially our work
to advance patient care and our profession.”
For more information about the Delta Pharmacy
Patient Care Management Project, call project coordinator Elisha Blades
at 601-984-2627 or visit http://pharmd.org/delta/.
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