What are the best new advances in building a web of care to help contain and manage chronic disease?
For Seena Haines, Professor and Associate Dean for Faculty of Gregory School of Pharmacy at Palm Beach Atlantic University, it’s integrating pharmacists into primary care models, with a special focus on reaching under-served and indigent patients.
A former dietician turned pharmacist with a specialty in ambulatory care, Haines is in a unique position to understand the value of collaborative care, particularly when it comes to cardiac health and diabetes. Pharmacists have healthcare provider status in 11 states, and there is a growing movement to integrate their work into primary care settings like clinics, physician offices and home-based health care services. Pharmacists can help find and respond to medication-related issues, including issues of cost, compliance and effectiveness; order lab tests; review patient progress and report results to physicians.
“There’s a workforce shortage in primary care in our family medicine space, and therefore nurse practitioners, doctors of pharmacy, case mangers and dietitians all have to come around and bring our own skills and expertise. Otherwise, the health outcomes we’re striving for are unreachable and too time-consuming. We have to be strategic in how we message patients, and maximize what we do,” Haines says.
Research shows that patients are typically significantly healthier as a result of working with a pharmacist, particularly when it comes to blood glucose levels and cardiac health. A Kaiser Permanente analysis of patients with coronary artery disease enrolled in its Collaborative Cardiac Care Service, comprising a nursing and clinical pharmacy team, showed that those enrolled within 90 days of an acute cardiac event were 89% less likely to die for any reason within 3.6 years compared to those not enrolled in the program. The earlier the program was started after a coronary event, the more effective it was in reducing mortality.
Another Kaiser study, this a 10-year-long retrospective, reported that including a clinical pharmacist on a care team for patients with type 2 diabetes lowered non-fatal cardiovascular disease risk by 5.5 percent over a decade and increase cost effectiveness, particularly over time.
Haines says expanding the primary care team helps bring medicine to special needs populations. She currently runs four foundation-supported safety-net clinics in Florida. Her students also do community outreach programs in schools on tobacco cessation and asthma management.
“Inspiring motivation is key, as well as being culturally targeted to groups you’re working with. It’s important to engage patients in their own care and treatment strategy,” she says.
Which other new models in collaborative care are making a difference in managing chronic diseases? Join our TEDMED Great Challenges Google+ Hangout tomorrow at 2pm ET to discuss strategies that work, and find out what’s on the horizon. The discussion will be moderated by Amy Lynn Smith, a writer + strategist and person living with diabetes. Special guests include Seena Haines, as well as Robert Gabbay, Chief Medical Officer of the Joslin Diabetes Center, and Loretta DiPietro, Chair of the Department of Exercise Science at the George Washington University School of Public Health and Health Services.