Promoting Collaborative Pharmacy Practice for High Blood Pressure
Submission Date: July 2018
State/Territory Submitted on the Behalf of: Wyoming
States/Territories Involved: Wyoming
Funding Source: CDC
CDC Funding:Yes
CDC Funding (Specified):(1305) State Public Health
Domain Addressed:Health Systems Strategies
Public Health Issue:- Nearly one in three residents of Wyoming has high blood pressure, a major risk factor for heart disease. The blood pressure medication non-adherence rate in Wyoming is 25%, indicating a need to improve management of high blood pressure.
- Blood pressure control improves when pharmacists work with doctors and other providers to manage patient treatment using a team-based approach.
- The Pharmacists’ Patient Care Process (PPCP) helps pharmacists use a consistent, patient-centered approach in collaboration with other providers on the healthcare team to optimize health outcomes. Collaborative Practice agreements (CPA) are a formal way for pharmacists to collaborate with healthcare team prescribers by specifying the functions prescribers can delegate to the pharmacist. For example, delegating functions related to initiating, modifying, or discontinuing medications for hypertension can increase efficiency by leveraging the pharmacist’s medication expertise and eliminating extra steps in the process.
- Health professional students and providers often need education about the value of team-based care, the PPCP, and CPAs.
- NACDD, in coordination with the CDC Division for Heart Disease and Stroke Prevention, works with a Wyoming state team that includes the Wyoming Department of Health’s Chronic Disease Prevention Program and the University of Wyoming School of Pharmacy to increase awareness of the PPCP, to increase implementation of the PPCP in pharmacy practice, and to increase the number of CPAs used in treating chronic disease patients.
- Through a series of presentations and lectures, the Chronic Disease Prevention Program educated practicing and student pharmacists about the role of the PPCP in chronic disease management and using CPAs to make the PPCP a sustainable practice. The School of Pharmacy provided technical assistance to 15 pharmacies as they worked to implement the PPCP, including: professional development training on hypertension management and motivational interviewing; reimbursement for costs associated with beginning implementation of the project; and help in developing data tracking and sharing. The Chronic Disease Prevention Program worked with pharmacists to provide the data they needed to evaluate potential opportunities for CPAs with nearby medical practices.
- The Chronic Disease Prevention Program will disseminate a survey to all Wyoming pharmacies to evaluate use of the PPCP and CPAs in high blood pressure management.
- Fifteen pharmacies implemented the PPCP as a result of the Wyoming Integrated Pharmacy Project implemented by the University of Wyoming School of Pharmacy. Patients in these pharmacy practices report greater medication adherence and increased self-efficacy in managing their condition. More Wyoming pharmacies are developing CPA proposals for prescribers in their area with plans to implement PPCP through a CPA in the near future.
- The University of Wyoming School of Pharmacy added education on the PPCP to its annual curriculum. It is evaluating the potential for embedding a requirement to use the PPCP into their fourth year pharmacy student rotations, a step that would support pharmacies that work with these students in their use of the PPCP. The lectures provided to pharmacy students increased their interest in the opportunities to apply the PPCP. Adding the requirement to use the PPCP in student rotations would promote even greater student understanding of the value of the PPCP and potentially improve students’ future pharmacy practice.
Heart Disease and Stroke
State Contact Information:
WY
Hannah Herold
Wyoming Department of Health
307-777-3579
hannah.herold@wyo.gov