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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThere are currently an estimated 56 million patients in the United States who do not have adequate access to primary health care. Pharmacists play an essential role in team-based patient care because of patients\u0027 reliance on medications to reduce disease-related complications. This article presents data from an ongoing evaluation of a collaborative practice model among physicians and pharmacists that provides care for patients with chronic disease in an urban safety net clinic.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials Diabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThere are currently an estimated 56 million patients in the United States who do not have adequate access to primary health care. As the number of patients with diabetes increases, this number is expected to increase. Team-based care has proven valuable for patients with diabetes and can extend health care to more people through nonphysician providers. Pharmacists play an essential role in team-based patient care because of patients\u0027 reliance on medications to reduce disease-related complications. It is possible that expanding the role of pharmacists in patient care could improve patient outcomes. In Virginia, pharmacist-physician collaborations were expanded in 2013 to include initiation, modification, continuation, and discontinuation of drug therapy.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EEvan M. Sisson, PharmD, MHA, Virginia Commonwealth University, Richmond, Virginia, USA, presented data from an ongoing evaluation of a collaborative practice model among physicians and pharmacists that provides care for patients with chronic disease in an urban safety net clinic. The population in this clinic faces significant barriers to care. Pharmacists provide 20 hours per week of comprehensive management of medications, which is about 70% of the overall care at this clinic. The care model is illustrated in \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/26\/17.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Collaborative Care Model\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1051768165\u0022 data-figure-caption=\u0022Collaborative Care Model\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/26\/17.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/26\/17.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/26\/17.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15031\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-4\u0022 class=\u0022first-child\u0022\u003ECollaborative Care Model\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003ECHW=community health worker; LPN=licensed practical nurse; MA=medical assistant; MD=medical doctor; NP=nurse practitioner; RD=registered dietitian. Reproduced with permission from D Dixon, PharmD, MHA, CDE.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-5\u0022\u003EThis analysis included 178 patients with \u2265 2 pharmacist visits during 2009, who were followed from 2010 to 2012. The mean age was 51.5 years (range, 18 to 65); 63% were women, 75% were black, and 19% were white. All patients had a medical history of hypertension (HTN); 33.7% had a history of hyperlipidemia; and 18.5% had diabetes.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EMean blood pressure (BP) was reduced from 156\/97 mm Hg at the initial visit to 131\/83 mm Hg at the end of follow-up. Mean non-HDL cholesterol was reduced from 154 mg\/dL to 129 mg\/dL.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPatients with stage 2 hypertension (n = 84) and all other patients (n = 94) had a similar mean number of visits to the pharmacist (7.5 vs 7.0) and to physicians (1.2 vs 1.1) between 2010 and 2012. However, during this period, patients with diabetes had more visits to the pharmacist compared with all other patients (12.4 vs 6.1). Among patients with diabetes, the number of visits to physicians was slightly fewer than those to pharmacists (1.0 vs 1.2).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDuring follow-up, the proportion of patients with diabetes with levels of HbA\u003Csub\u003E1c\u003C\/sub\u003E \u0026lt; 7% increased from 33% to 70% (p \u0026lt; .05). HbA\u003Csub\u003E1c\u003C\/sub\u003E decreased from a mean of 8.4% to 6.4% in 2012 (p = .0008). The improvement in HbA\u003Csub\u003E1c\u003C\/sub\u003E levels \u0026lt; 7% and the reduction in mean HbA1c levels occurred by 2010 and were maintained throughout the observation period. Initially, only 9% of patients with diabetes had BP levels \u0026lt; 130\/80 mm Hg, and this increased to 24% of patients by 2010 and was maintained at 2012 (p = .18).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe collaborative practice model between pharmacists and primary care practitioners was able to achieve and maintain positive health outcomes. BP decreased among patients with HTN. Among patients with diabetes, there was a significant reduction in HbA1c levels and a nonsignificant reduction in BP. This model warrants further study in other settings but may offer one way in which to increase access to high-quality health care.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/26\/17.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzovc1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzovc1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}