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Clinical Pharmacists Significantly Improve Patient Outcomes, Advance Health Equity

Study shows patients with personalized pharmacist-led medication management programs at federally qualified health centers effectively managed complex chronic disease and lowered risk of death by 20%



Clinical pharmacists play a key role in patient health and management of chronic conditions. (Photo by Erica Lee for Direct Relief)

Recent research published in the Journal of the American College of Clinical Pharmacy shows that investments made in clinical pharmacist-led patient care can substantially improve health measures in low-income patients facing a debilitating chronic disease.

The paper, titled “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,” describes a study commissioned by BD (Becton, Dickinson and Company), a leading global medical technology company, along with Direct Relief and the National Association of Community Health Centers (NACHC), which found that patients enrolled in a comprehensive medication management program at federally qualified health centers (FQHC) saw their Hemoglobin A1c (HbA1c) scores decrease by 1.2% in six months — equating to an estimated 20% lower risk of death. Evaluated decreases are clinic average gains and are an important first step to better informing integrated patient management programs with the goal of mitigating the consequences of life-threatening chronic diseases at the patient level.

The study analyzed clinical pharmacy approaches at eight federally qualified health centers that received funding through the BD Helping Build Healthy Communities™ grant initiative, which was established in 2013 and funded by BD and the BD Foundation, and implemented by Direct Relief and NACHC in order to support comprehensive medication management services for low-income patients. Clinics were evaluated for two years and included awardees from 2017, 2018 and 2019.

“It’s easy to prescribe medication, but to actually maximize the benefit that the patient gets from that medication requires comprehensive medication management that goes beyond the typical 15-minute provider visit,” said Dr. Sonak Pastakia from Purdue University School of Pharmacy, lead author of the study. “We found that when patients review their diagnosis and coinciding medications with a team, led by a clinical pharmacist, as well as social workers and behavioral health specialists, the health outcome of their chronic disease improve beyond what is seen in a typical clinical visit.”

FQHCs are community-based providers that receive funding under the Public Health Service Act in order to provide primary care services in underserved areas and often work under significant budget constraints despite caring for nearly 30 million patients annually, 67% of whom earn an income below the federal poverty line. Because standard Medicaid coverage does not often reimburse health care providers for novel programs like comprehensive medication management, non-federal funding sources like philanthropic investments are instrumental in helping health centers care for vulnerable patient populations.

This is especially true of people living with diabetes as a 1% drop in their average blood sugar over 3 months (i.e., glycosylated hemoglobin [HbA1c]) can save the health care system an estimated $685 to $950 annually per patient, while also reducing the risk of serious longer-term health issues.

Damon Taugher, vice president of Global Programs at Direct Relief and a co-author of the paper, said, “This study goes a long way toward proving the hypothesis that underpins the BD Helping Build Healthy Communities program — that investing in health centers positively impacts clinical outcomes for patients.”

Jennifer Farrington senior director of BD social investing and vice president of the BD Foundation, added, “We launched the BD Helping Build Healthy Communities program with Direct Relief and NACHC nearly a decade ago to address the disparity in which health care was being provided to vulnerable patients and populations across our health systems. We partnered with community health centers in high-need areas of the U.S. to help enable them to provide culturally relevant care that meets the needs of their patients and their community. As part of our ongoing commitment to building stronger, more resilient communities, we will continue to serve as a valued partner to community health centers as we work toward advancing access to equitable health care.”

Chief Medical Officer of NACHC, Ron Yee, said, “Nationwide, we see the successful results of this collaboration with Community Health Centers in the field. Pharmacists work with each patient through face-to-face visits, telehealth, patient education, medication management, addressing medication access concerns through the discount 340B drug program and monitoring, and providing follow-up in collaboration with the primary care provider. Health centers are caring for increasing numbers of patients who are older and suffering from multiple chronic health conditions. Medication management is essential to improving their health and lowering the risk of hospitalization.”

Read the full paper: 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 – Journal of the American College of Clinical Pharmacy

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