Clinical Pharmacists Provide Outpatient Medication Management to Patients With Severe Diabetes and Those on Anticoagulants, Leading to Improved Outcomes and Lower Costs
Snapshot
Summary
Clinical pharmacists working in 12 community health centers in the Harris County Hospital District provide direct care to high-risk patients, including those with severe diabetes, those on anticoagulants, and others. Most patients are indigent or elderly, and many are Hispanic. The pharmacists perform medication reconciliation, monitor patients according to key indicators, adjust medication doses as necessary, and educate patients and providers about managing these conditions. The program has led to significant improvements in health outcomes, including improvements in blood glucose levels among diabetics and international normalized ratio levels among those on anticoagulants, prevention of many adverse drug events, and meaningful cost savings due to reductions in emergency department visits and inpatient admissions.
Evidence Rating
Moderate: The evidence consists of before-and-after comparisons of key outcomes measures, including the percentage of anticoagulation patients achieving their international normalized ratio goal and average hemoglobin A1c, cholesterol, and blood pressure levels.
Developing Organizations
Harris County Hospital District
Houston, TX
Date First Implemented
2001
The program began on a small scale in 2001 and was expanded to all Harris County Hospital District clinics beginning in 2006.
Patient Population
Age > Middle-aged adult (45-64 years); Senior adult (65-79 years); Geographic Location > Metropolitan area; Race and Ethnicity > Hispanic/Latino-Latina; Vulnerable Populations > Co-occuring disorders; Immigrants; Impoverished; Medically uninsured; Medically or socially complex; Racial minorities
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http://www.innovations.ahrq.gov/content.aspx?id=2359
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