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Abstract：
OBJECTIVE: Evaluate a cardiovascular care intervention intended to increase access to comprehensive medication management (CMM) pharmacy care and improve vascular health goals among socially disadvantaged patients.
METHODS: Retrospective electronic health records-based evaluation.
METHODS: Thirteen health care clinics serving socially vulnerable neighborhoods within a large health system.
METHODS: Hypertensive and hyperlipidemic adult patients.
METHODS: CMM pharmacists increased recruitment among patients who met clinical criteria in clinics serving more diverse and socially vulnerable communities. CMM pharmacists partnered with patients to work toward meeting health goals through medication management and lifestyle modification.
METHODS: Changes in the engagement of socially disadvantaged patients between preintervention and intervention time periods; vascular health goals (ie, controlled blood pressure, appropriate statin and aspirin therapies, and tobacco nonuse); and the use of health system resources by CMM care group.
RESULTS: The intervention indicated an overall shift in sociodemographics among patients receiving CMM care (fewer non-Hispanic Whites: N = 1988, 55.81% vs N = 2264, 59.97%, P < .001; greater place-based social vulnerability: N = 1354, 38.01% vs N = 1309, 34.68%, P = .03; more patients requiring interpreters: N = 776, 21.79% vs N = 698, 18.49%, P < .001) compared to the preintervention period. Among patients meeting intervention criteria, those who partnered with CMM pharmacists (N = 439) were more likely to connect with system resources (social work: N = 47, 10.71% vs 163, 3.74%, P < .001; medical specialists: N = 249, 56.72% vs N = 1989, 45.66%; P < .001) compared to those without CMM care (N = 4356). Intervention patients who partnered with CMM pharmacists were also more likely to meet blood pressure (N = 357, 81.32% vs N = 3317, 76.15%, P < .001) and statin goals (N = 397, 90.43% vs N = 3509, 80.56%, P < .001) compared to non-CMM patients.
CONCLUSIONS: The demographics of patients receiving CMM became more diverse with the intervention, indicating improved access to CMM pharmacists. Cultivating relationships among patients with greater social disadvantage and cardiovascular disease and CMM pharmacists may improve health outcomes and connect patients to essential resources, thus potentially improving long-term cardiovascular outcomes.
METHODS: Retrospective electronic health records-based evaluation.
METHODS: Thirteen health care clinics serving socially vulnerable neighborhoods within a large health system.
METHODS: Hypertensive and hyperlipidemic adult patients.
METHODS: CMM pharmacists increased recruitment among patients who met clinical criteria in clinics serving more diverse and socially vulnerable communities. CMM pharmacists partnered with patients to work toward meeting health goals through medication management and lifestyle modification.
METHODS: Changes in the engagement of socially disadvantaged patients between preintervention and intervention time periods; vascular health goals (ie, controlled blood pressure, appropriate statin and aspirin therapies, and tobacco nonuse); and the use of health system resources by CMM care group.
RESULTS: The intervention indicated an overall shift in sociodemographics among patients receiving CMM care (fewer non-Hispanic Whites: N = 1988, 55.81% vs N = 2264, 59.97%, P < .001; greater place-based social vulnerability: N = 1354, 38.01% vs N = 1309, 34.68%, P = .03; more patients requiring interpreters: N = 776, 21.79% vs N = 698, 18.49%, P < .001) compared to the preintervention period. Among patients meeting intervention criteria, those who partnered with CMM pharmacists (N = 439) were more likely to connect with system resources (social work: N = 47, 10.71% vs 163, 3.74%, P < .001; medical specialists: N = 249, 56.72% vs N = 1989, 45.66%; P < .001) compared to those without CMM care (N = 4356). Intervention patients who partnered with CMM pharmacists were also more likely to meet blood pressure (N = 357, 81.32% vs N = 3317, 76.15%, P < .001) and statin goals (N = 397, 90.43% vs N = 3509, 80.56%, P < .001) compared to non-CMM patients.
CONCLUSIONS: The demographics of patients receiving CMM became more diverse with the intervention, indicating improved access to CMM pharmacists. Cultivating relationships among patients with greater social disadvantage and cardiovascular disease and CMM pharmacists may improve health outcomes and connect patients to essential resources, thus potentially improving long-term cardiovascular outcomes.
摘要：
目的：评估心血管护理干预措施，旨在增加社会弱势患者获得全面药物管理（CMM）药学护理的机会，并改善血管健康目标。
方法：基于电子健康记录的回顾性评估。
方法：13个医疗诊所为大型卫生系统内的社会脆弱社区提供服务。
方法：高血压和高脂血症的成人患者。
方法：CMM药剂师在服务于更多样化和社会弱势社区的诊所中增加了符合临床标准的患者的招募。CMM药剂师与患者合作，通过药物管理和生活方式改变来实现健康目标。
方法：社会弱势患者在干预前和干预时间段之间的参与变化；血管健康目标（即，控制血压,适当的他汀类药物和阿司匹林治疗，和不使用烟草)；以及CMM护理小组对卫生系统资源的使用。
结果：干预表明接受CMM护理的患者的社会人口统计学发生了总体变化（非西班牙裔白人较少：N=1988，55.81％vsN=2264，59.97％，P<.001；基于地点的社会脆弱性更大：N=1354，38.01%vsN=1309，34.68%，P=0.03;更多的患者需要翻译：N=776，21.79％vsN=698，18.49％，P<.001)与干预前时期相比。在符合干预标准的患者中，与CMM药剂师合作的人（N=439）更有可能与系统资源联系（社会工作：N=47，10.71％vs163，3.74％，P<.001；医学专家：N=249，56.72％vsN=1989，45.66％；P<.001）与没有CMM护理的患者（N=4356）相比。与CMM药剂师合作的干预患者也更有可能达到血压（N=357，81.32％vsN=3317，76.15％，P<.001）和他汀类药物目标（N=397，90.43％vsN=3509，80.56％，P<.001)与非CMM患者相比。
结论：通过干预，接受CMM的患者的人口统计学变得更加多样化，表明改善了对CMM药剂师的访问。培养具有更大社会劣势和心血管疾病的患者与CMM药剂师之间的关系可以改善健康结果，并将患者与基本资源联系起来。从而有可能改善长期心血管结局.
方法：基于电子健康记录的回顾性评估。
方法：13个医疗诊所为大型卫生系统内的社会脆弱社区提供服务。
方法：高血压和高脂血症的成人患者。
方法：CMM药剂师在服务于更多样化和社会弱势社区的诊所中增加了符合临床标准的患者的招募。CMM药剂师与患者合作，通过药物管理和生活方式改变来实现健康目标。
方法：社会弱势患者在干预前和干预时间段之间的参与变化；血管健康目标（即，控制血压,适当的他汀类药物和阿司匹林治疗，和不使用烟草)；以及CMM护理小组对卫生系统资源的使用。
结果：干预表明接受CMM护理的患者的社会人口统计学发生了总体变化（非西班牙裔白人较少：N=1988，55.81％vsN=2264，59.97％，P<.001；基于地点的社会脆弱性更大：N=1354，38.01%vsN=1309，34.68%，P=0.03;更多的患者需要翻译：N=776，21.79％vsN=698，18.49％，P<.001)与干预前时期相比。在符合干预标准的患者中，与CMM药剂师合作的人（N=439）更有可能与系统资源联系（社会工作：N=47，10.71％vs163，3.74％，P<.001；医学专家：N=249，56.72％vsN=1989，45.66％；P<.001）与没有CMM护理的患者（N=4356）相比。与CMM药剂师合作的干预患者也更有可能达到血压（N=357，81.32％vsN=3317，76.15％，P<.001）和他汀类药物目标（N=397，90.43％vsN=3509，80.56％，P<.001)与非CMM患者相比。
结论：通过干预，接受CMM的患者的人口统计学变得更加多样化，表明改善了对CMM药剂师的访问。培养具有更大社会劣势和心血管疾病的患者与CMM药剂师之间的关系可以改善健康结果，并将患者与基本资源联系起来。从而有可能改善长期心血管结局.
