Million Hearts Health Equity Implementation

The National Association of Chronic Disease Directors funded six organizations from across the US to effectively implement Million Hearts® strategies among priority populations between January – July 2023 as part of The Million Hearts® Health Equity Implementation project to reduce health disparities and improve cardiovascular health.

All funding recipients shared their results and progress towards achieving this goal during a virtual meeting on July 26, 2023, that included representatives from the Centers for Disease Control and Prevention (CDC), NACDD, and cardiovascular health staff from State Health Departments.

UConn Health’s Maternal-Fetal Medicine practice in Farmington, Connecticut supplied 212 pregnant and postpartum women at risk for hypertensive disorders of pregnancy with a Preeclampsia Foundation Cuff Kit and blood pressure monitoring education. The practice serves many women with low incomes and women from racial/ethnic minority groups were prioritized for services due to their higher risk for preeclampsia.

  • The project offered providers the option to refer women for a telephone visit with a pharmacist to promote medication adherence.
  • An engaged team helped make the project successful, including a physician champion, nurses, a Women’s Health Community Health Specialist, electronic health record analysts, and many more dedicated people.
  • UConn Health aims to sustain this program through approval as a contracted pharmacy vendor for Medicaid and through private support.

Huddle Up Moms, an organization in Roanoke, Virginia founded to bring pregnant and postpartum women together for mutual support, provided blood pressure cuffs and care navigation to underserved pregnant women.

  • The women engaged in an education and monitoring program with a care coordinator, who also connected them to community resources to address social determinants of health (SDOH)-related needs.
  • A wide range of other community-based organizations and local clinical partners were encouraged to refer pregnant women to the program, with a total 75 Preeclampsia Foundation Cuff Kits distributed to these partners.
  • This project significantly expanded the services Huddle Up Moms can offer to its participants as well as strengthening key professional relationships in the area.

The West Virginia University (WVU) Medicine Heart Failure clinic in Morgantown, West Virginia expanded a pharmacist-led telemedicine heart failure medication optimization program internally and in select primary care clinics in the West Virginia Practice-Based Research Network (WVPBRN).

  • The project aimed to reduce barriers to specialty care access; improve the percent of heart failure patients receiving appropriate medications; and improve heart failure symptoms, quality of life, cardiac function, and mortality.
  • One hundred seventy-two blood pressure cuffs and 100 scales were provided to patients in rural Appalachian areas who went on to participate in 144 tele-pharmacy encounters.
  • WVU plans to use the data gathered in this project to advocate for WV Medicaid to cover the cost of SMBP cuffs for members.

St. James Healthcare, a rural hospital in Butte, Montana serving a 7-county region in the southwest of the state provided blood pressure cuffs and scales to patients admitted with a diagnosis of heart failure, with an emphasis on residents of rural areas.

  • Participants received education on their diagnosis, medications, and use of the cuff and scale. A pharmacist and a Cardiac Rehab Therapist also followed up with participants after hospital discharge and coordinated with the care team as needed.
  • Preliminary results show a significant change in hospital readmission for heart failure patients from 34% prior to program launch to 7.9% at its lowest.
  • Results from the project will help inform the hospital system’s planned implementation of remote patient monitoring.

Midvale Community Building Community (CBC) in Midvale, Utah is a charitable clinic serving low-income, uninsured Latino patients. Midvale CBC also subscribed to the Dispensary of Hope, enabling the clinic to provide free medications to patients at the time of their visit. Implementing this project led Midvale CBC to open a new weekly hypertension clinic to provide ongoing care for enrolled patients, and to become the first charitable clinic in Utah to be licensed as a Charity Clinic.

  • Midvale CBC supplied blood pressure cuffs to 150 patients at risk for hypertension and screened 341 adults served in their mental health and dental programs for tobacco use.
  • Community Health Workers (CHWs) provided education, follow-up, and connections to community resources.
  • Midvale CBC was recently named a 2023 Hypertension Hero by the National Hypertension Control Roundtable for this work.

University of Pittsburgh School of Pharmacy and the Pennsylvania Pharmacists Care Network (PPCN) supported teams serving low-income patients with hypertension at 5 pharmacies in underserved areas of the state.

  • A pharmacist champion and intern at each site identified Medicaid patients to receive services including, but not limited to, 1) BP screenings and follow up; 2) medication adherence support; 3) BP medication therapy management; 4) care coordination; 5) lifestyle modification counseling; 6) SDOH screening and linkages to resources.
  • One hundred ten unique patients received hypertension services at participating pharmacies, engaging in a total of 162 patient encounters. Pharmacies also screened 73 patients for SDOH-related needs.
  • Results and lessons learned from this project will be shared throughout PPCN’s statewide network of over 180 pharmacies.

Visit Million Hearts Health Equity Implementation 2023 to view a recording of the meeting and the NACDD Cardiovascular Health page to learn more.

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