权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Pharmacist-CHW Team to Improve Medication Adherence and Reduce Hypertension Disparities

药剂师-CHW 团队致力于提高用药依从性并减少高血压差异

基本信息

批准号：
10676327
负责人：
Jeannie Kim Lee
金额：
$ 53.15万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-06 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10676327
关键词：
Address Adherence African American Automobile Driving Belief Blood Pressure Body mass index Cardiovascular Diseases Cardiovascular system Caring Cessation of life Chronic Disease Clinical Clinical Pharmacists Communities Community Health Aides Data Collection Death Rate Diagnosis Disparity Distal Dose Education Effectiveness Electronic Health Record Ethnic Population Face Fright Glycosylated hemoglobin A Health Health Insurance Health Services Accessibility Health behavior Healthcare Heart Diseases Hypertension Immigrant Individual Insurance Coverage Intention Intervention Kidney Diseases Latino Linguistics Low Income Population Low income Low-Density Lipoproteins Measures Medication Management Medicine Modeling Neighborhood Health Center Outcome Participant Patient Self-Report Patients Pharmaceutical Preparations Pharmacists Play Polypharmacy Population Heterogeneity Poverty Primary Care Qualifying Randomized Randomized, Controlled Trials Reduce health disparities Regimen Reporting Research Research Personnel Research Project Grants Resources Risk Factors Role Self Management Services Site Social Environment Social support Stroke Surveys Transportation Vietnamese Vulnerable Populations Waiting Lists Work accountable care organization adherence rate adverse outcome blood pressure control cardiovascular risk factor care coordination care providers caucasian American clinical practice comorbidity cost design disparity reduction effectiveness evaluation effectiveness testing ethnic disparity ethnic minority experience food insecurity health literacy high risk high risk population improved innovation low health literacy mathematical ability medication compliance member minority patient neglect patient navigator patient oriented pill post intervention premature prevent primary care provider programs racial disparity racial minority racial minority population racial population response skills social social culture theories

项目摘要

Abstract The U.S. faces profound racial and ethnic disparities in hypertension, which are exacerbated by disparities in medication adherence. Yet few existing medication adherence interventions are tailored to address the specific cultural beliefs of diverse populations who also face significant structural barriers to adherence associated with poverty, access to care and food insecurity. The proposed Improving Medication Adherence with Pharmacist and CHW Team (IMPaCT) intervention responds to the call for adherence interventions that are tailored for the specific needs of minority racial-ethnic groups. IMPaCT is a practice-based randomized controlled trial (RCT) to test the effectiveness of a comprehensive, individually- and culturally-tailored intervention for high-risk patients with hypertension, polypharmacy and low adherence. IMPaCT leverages the specialized expertise of a clinical pharmacist together with a community health worker (CHW) who will serve as cultural broker and patient navigator to address individual, clinical, social-cultural, and structural barriers to adherence. This comprehensive and tailored, coordinated care intervention aims to improve medication adherence and hypertension outcomes among African-American, Latino and Vietnamese immigrant patients. The proposed practice-based RCT is designed to meet the following specific aims: Aim 1: Implement IMPaCT, an innovative, tailored adherence intervention delivered by a pharmacist and CHW team. Aim 2: Determine the short- and long-term effectiveness of IMPaCT by assessing pre- to post-intervention changes in: a) medication adherence (proximal outcome) and blood pressure (BP, distal outcome), and b) other comorbid health outcomes (e.g., HbA1c, BMI) using a randomized controlled trial. Aim 3: Identify factors associated with IMPaCT effectiveness including: a) tailored intervention features, b) medication beliefs, c) barriers to adherence, d) intervention dose, e) health literacy, and f) cultural group. We will follow an intention-to-treat randomized design using a waitlist control with 450 African-American, Latino, and Vietnamese patients with hypertension and low (<80%) medication adherence. Data collection via pill count, self-report, the electronic health record, and clinical measures will assess medication adherence, BP and other factors at baseline (pre-intervention) and at 4, 10, and 24 weeks post-intervention. IMPaCT is an innovative coordinated care team intervention to improve medication adherence and blood pressure derived from research findings that builds on existing clinical practice. Designed with an eye towards sustainability, IMPaCT incorporates billable pharmacist and CHW services for patients with low medication adherence and high burdens of chronic illness and preventable consequences. IMPaCT offers interprofessional team care with comprehensive expertise and complementary skill sets that mitigate the silo effect of specialized medicine to deliver primary care to diverse, high-risk populations experiencing disparities in hypertension.

摘要