Using a Team-based Approach to Managing Medication for Chronic Diseases

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Submission Date: August 2018

State/Territory Submitted on the Behalf of: Arizona

States/Territories Involved: Arizona

Domain Addressed:

Health Systems Strategies

Public Health Issue:

  • The Community Preventive Services Task Force recommends team-based care to improve patients’ blood pressure and to control type 2 diabetes.
  • Patient care teams include the patient’s primary care provider and other professionals, such as pharmacists and community health workers.
  • The Pharmacists’ Patient Care Process (PPCP) helps pharmacists to optimize patient health outcomes by using a consistent approach in collaboration with other providers on the healthcare team. 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.

Program Action:

  • NACDD, in coordination with the Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention, works with an Arizona state team to accelerate team-based care by applying the PPCP and using CPAs to manage high blood pressure and diabetes.
  • The Arizona Department of Health Services (ADHS) and the University of Arizona College of Pharmacy Medication Management Center (MMC) established a state task force.
  • The Arizona Pharmacy Association and the Colleges of Pharmacy Preceptor group from Midwestern University and the University of Arizona, in collaboration with ADHS, implemented a survey designed to assess application of the PPCP, use of CPAs, and other medication issues.
  • Half of the survey respondents, who represent teaching preceptors and pharmacy association members, indicated that they were aware of the PPCP. A little more than a third of respondents stated that they had some form of a CPA protocol at their practice site. The four most common disease states covered under these CPAs included diabetes and hypertension.

Impact/Accomplishments:

  • The MMC established CPAs with two rural community health centers and provided medication therapy management services to more than 600 of the centers’ clients, many of whom are considered high-risk.  ADHS has a formal agreement with MMC to provide medication therapy management services by telephone with pharmacists in rural underserved areas. MMC also set up an agreement with both clinics to facilitate thorough telephonic data collection.
  • To meet the need for education indicated by the survey results, the task force implemented or will implement education and training to promote the PPCP and CPAs, as follows:
    • Presentation on the PPCP to 30 physicians from Abacus Health, an accountable care organization.
    • Implementation of a joint pharmacy and healthcare track during the ADHS CQI Symposium for 90 attendees and dedication of a larger than usual portion of the agenda to pharmacy management and quality improvement. This topic likely will become a regularly occurring part of this annual conference.
    • Presentation to the Arizona Diabetes Coalition Diabetes Leadership Council on the PPCP. This project’s pharmacy lead also led training for staff at their primary practice site on the PPCP and its role in that organization.
    • A scheduled presentation to the American Society of Health-System Pharmacists National Pharmacy Preceptors Conference on the PPCP.

Program Areas:

Diabetes, Heart Disease and Stroke, Public Health Practice, Tobacco

State Contact Information:

AZ
Stephanie Forbes, PharmD
University of Arizona College of Pharmacy, Medication Management Center
520-626-1793
forbes@pharmacy.arizona.edu

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