Effectiveness of advanced practice pharmacy services among American Indian and Alaska Native adults with diabetes
Effectiveness of advanced practice pharmacy services among American Indian and Alaska Native adults with diabetes
批准号:
9379777
负责人:
SPERO MARTIN MANSON
金额:
$25.66万
依托单位国家:
美国
项目类别:
财政年份:
2017
资助国家:
美国
项目状态:
已结题
起止时间:
2017-07-01 至 2020-06-30
关键词:
AddressAdultAffectAlaska NativeAmerican IndiansAreaBlood PressureCardiovascular DiseasesCaringCharacteristicsCholesterolChronicClinical PharmacistsClinics and HospitalsCollaborationsColoradoCommunitiesComorbidityComplexDataDeath RateDiabetes MellitusDiagnosisEconomicsEffectivenessElectronic Health RecordEnd stage renal failureEthnic groupFaceFundingGeneral PopulationGeographyGoalsHealthHealth ResourcesHealth ServicesHealth Services AccessibilityHealth StatusHealth educationHealth systemHealthcareHeart DiseasesHigh PrevalenceHome environmentHouseholdIncomeInterventionLaboratoriesLeadershipLength of StayLife StyleMedicalMedical centerMethodsModelingMonitorMorbidity - disease rateNative-BornNatureNon-Insulin-Dependent Diabetes MellitusNot Hispanic or LatinoOutcomePatient riskPatient-Focused OutcomesPatientsPersonsPharmaceutical PreparationsPharmaceutical ServicesPharmacistsPharmacy facilityPhysiciansPlayPoliciesPopulationPrevalencePrimary Health CareProviderReportingResearch InfrastructureResourcesRiskRisk FactorsRoleRuralServicesSiteStrokeStructureSupervisionSystemTechniquesTestingTimeTranslatingTreatment CostTribesUnited States Indian Health ServiceUniversitiesUpdateVisitcardiovascular disorder riskcostcost effectivecost effectivenessearly onsetelectronic dataexperiencehealth care deliveryhigh riskimprovedimproved outcomeinsightinstitutional capacitymedication compliancemeetingsmortalitymultidisciplinarypatient orientedpatient registrypreventracial and ethnicservice utilizationtelehealthtime usetribal leaderurban Native American
中文摘要
美国印第安人和阿拉斯加土著成人与先进实践药房服务的有效性
英文摘要
Effectiveness of advanced practice pharmacy services among American Indian and Alaska Native adults with
diabetes
The Indian Health Service (IHS) funds services for approximately 2.2 million American Indians and Alaska
Natives (AI/ANs).IHS health care resources are strained due to limited per capita spending, the
disproportionate high costs of treating AI/ANs with diabetes, and provider shortages. All-cause mortality of
AI/ANs is 46% higher than that of non-Hispanic whites, attributable in part to higher mortality associated with
diabetes. Within IHS, the provision of advanced practice pharmacy (APP) services for adults with diabetes has
increased. During fiscal year (FY) 2008, approximately 1% of AI/ANs with diabetes used APP. Just 5 years
later, 9.6% (n=4,620) had at least 1 APP visit in FY2013. To date, IHS has not had the institutional capacity to
fully characterize the provision of APP services, nor study its effectiveness or costs.
Given the need to both improve outcomes for patients with diabetes and effectively utilize limited IHS
resources, this study's goal is to describe and assess the effectiveness of emerging models of APP within IHS
for treatment of diabetes. Since 2010, IHS and Tribes have collaborated with the Centers for American Indian
and Alaska Native Health at the University of Colorado to create a longitudinal data infrastructure with health
status, service utilization, and treatment cost data for over 640,000 AI/ANs who represent nearly 30% of
AI/ANs who use IHS services. The infrastructure, created through the Improving Health Care Delivery Data
Project, is a synthesis of existing electronic data from multiple IHS platforms and currently includes data for 7
years (FY2007-2013) for 15 project sites. We propose to continue this collaboration by updating the
infrastructure with recent data (FY2014-2017) to evaluate APP effectiveness among AI/AN adults with
diabetes using statistical techniques made possible by the longitudinal data. The study has 3 aims:
1. Characterize APP delivery models for adults with diabetes within sites and over time using site
characteristics and patient health risk profiles (e.g., glycemic level [A1c], blood pressure [BP],
cholesterol [CHL], cardiovascular disease). We anticipate that up to 3 models may emerge (e.g.,
Targeted, Limited, and General); and
2. For each APP model, evaluate the nature and extent of the relationship between patient APP use and
outcomes. Within each model, we expect that APP will improve medication adherence and A1c, BP, and
CHL levels, and reduce onset of complications and preventable hospital stays; and
3. Estimate APP delivery costs, treatment cost changes associated with lower use of other health services,
and cost-effectiveness. We expect the APP models to be cost-effective.
1
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Colorado Resource Center for Tribal Epidemiology Centers
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批准号:10532624
-
项目类别:
-
资助金额:$228.6万
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财政年份:2022
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负责人:SPERO MARTIN MANSON
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依托单位:
Colorado Resource Center for Tribal Epidemiology Centers
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批准号:10666650
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项目类别:
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资助金额:$219.29万
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财政年份:2022
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负责人:SPERO MARTIN MANSON
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依托单位:
Collaborative Hub to Reduce the Burden of Suicide among Urban American Indian and Alaska Native Youth
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批准号:10186826
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项目类别:
-
资助金额:$24.18万
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财政年份:2017
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负责人:SPERO MARTIN MANSON
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依托单位:
Collaborative Hub to Reduce the Burden of Suicide among Urban American Indian and Alaska Native Youth
-
批准号:10186827
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项目类别:
-
资助金额:$82.63万
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财政年份:2017
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负责人:SPERO MARTIN MANSON
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依托单位:
Transition to Recovery
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批准号:10310687
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项目类别:
-
资助金额:$21.01万
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财政年份:2017
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负责人:SPERO MARTIN MANSON
-
依托单位:
Consortium Core
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批准号:9196918
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项目类别:
-
资助金额:$54.56万
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财政年份:2016
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负责人:SPERO MARTIN MANSON
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依托单位:
Technology-Based Health Services for American Indian and Alaska Native People
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批准号:9071421
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项目类别:
-
资助金额:$35.31万
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财政年份:2016
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负责人:SPERO MARTIN MANSON
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依托单位:
Trauma Screening, brief intervention and referral among AI/AN adults
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批准号:8859986
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项目类别:
-
资助金额:$30.72万
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财政年份:2015
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负责人:SPERO MARTIN MANSON
-
依托单位:
Technology-Based Health Services for American Indian and Alaska Native People
-
批准号:8859987
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项目类别:
-
资助金额:$13.22万
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财政年份:2015
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负责人:SPERO MARTIN MANSON
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依托单位:
RESEARCH TRAINING/EDUCATION CORE
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批准号:8859991
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项目类别:
-
资助金额:$39.66万
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财政年份:2015
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负责人:SPERO MARTIN MANSON
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依托单位:
CENTER FOR AMERICAN INDIAN AND ALASKA NATIVE DIABETES TRANSLATION RESEARCH
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批准号:9186861
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项目类别:
-
资助金额:$62.81万
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财政年份:2012
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负责人:SPERO MARTIN MANSON
-
依托单位:
CENTER FOR AMERICAN INDIAN AND ALASKA NATIVE DIABETES TRANSLATION RESEARCH
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批准号:9766241
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项目类别:
-
资助金额:$50.45万
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财政年份:2012
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负责人:SPERO MARTIN MANSON
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依托单位:
Trauma Screening, brief intervention and referral among AI/AN adults
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批准号:8354749
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项目类别:
-
资助金额:$20.82万
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财政年份:2012
-
负责人:SPERO MARTIN MANSON
-
依托单位:
Technology-Based Health Services for American Indian and Alaska Native People
-
批准号:8354750
-
项目类别:
-
资助金额:$20.82万
-
财政年份:2012
-
负责人:SPERO MARTIN MANSON
-
依托单位:
RESEARCH TRAINING/EDUCATION CORE
-
批准号:8354757
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项目类别:
-
资助金额:$20.82万
-
财政年份:2012
-
负责人:SPERO MARTIN MANSON
-
依托单位:
Administrative Core
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批准号:8453619
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项目类别:
-
资助金额:$15.29万
-
财政年份:2012
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负责人:SPERO MARTIN MANSON
-
依托单位:
Adminstrative Core
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批准号:8354753
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项目类别:
-
资助金额:$20.82万
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财政年份:2012
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负责人:SPERO MARTIN MANSON
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依托单位:
Center for American Indian and Alaska Native Diabetes Translational Research
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批准号:8546347
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项目类别:
-
资助金额:$47.91万
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财政年份:2011
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负责人:SPERO MARTIN MANSON
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依托单位:
Administrative Core
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批准号:10683205
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项目类别:
-
资助金额:$12.79万
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财政年份:2011
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负责人:SPERO MARTIN MANSON
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依托单位:
Center for American Indian and Alaska Native Diabetes Translational Research
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批准号:8715780
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项目类别:
-
资助金额:$50.79万
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财政年份:2011
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负责人:SPERO MARTIN MANSON
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依托单位:
海外基金