Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers

Abstract

Introduction: Appropriate management of chronic diseases, including proper use of medications, can lead to better disease control, decrease disease-related complications, and improve overall health. Pharmacists have been shown to positively affect chronic disease outcomes through medication therapy management (MTM). The primary objectives of this project are to increase the number of patients with (1) A1c in control and (2) blood pressure in control; secondary objectives are to (3) describe number and type of medication-related problems identified and resolved by pharmacists providing MTM in Federally Qualified Health Centers (FQHCs), (4) identify potential (pADEs) and actual adverse drug events (ADEs), and refer patients to diabetes self-management education classes, as needed.

Methods: This multisite, prospective, descriptive pilot study engaged three FQHC sites with distinct models of established pharmacist MTM services to care for patients with uncontrolled diabetes and/or hypertension. Data were reported in aggregate regarding primary and secondary outcomes.

Results: As of December 2015, 706 patients were enrolled in the project. Of the 422 with uncontrolled diabetes, 52.84% (n = 223) had an A1c <9%; 72 patients (17.06%) achieved an A1c between 8% and 9%, 19.19% (n = 81) of patients achieved an A1c <8% and ≥7%, and 16.59% (n = 70) of patients achieved an A1c <7%. The percentage of patients with blood pressure <140/90 mm Hg improved to 65.21%.

Conclusion: Pharmacist-provided MTM can improve chronic disease intermediate outcomes for medically underserved patients in FQHCs.

Keywords: community health centers; medications; pharmacy; primary care; program evaluation.

Figure 1.

A1c measurement of medication therapy management (MTM) project enrollees by month, Ohio, March 2014 to December 2015. Since the beginning of the project, 223 diabetic patients who were enrolled in MTM services decreased their A1c to a level considered in control (<9%). Among those, 70 lowered their A1c to a level considered tight control (<7%).

Figure 2.

Blood pressure measurement of medication therapy management (MTM) project enrollees by month, Ohio, March 2014 to December 2015. Since the beginning of the project, 283 hypertensive patients who were enrolled in MTM services decreased their blood pressure to a level considered in control (<140/90 mm Hg).