Use of clinical pharmacy services by American Indians and Alaska Native adults with cardiovascular disease.
American Indian
cardiovascular disease
health services research
medication management
outcomes
population health
social determinants of health
Journal
Journal of the American College of Clinical Pharmacy : JACCP
ISSN: 2574-9870
Titre abrégé: J Am Coll Clin Pharm
Pays: United States
ID NLM: 101723133
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
14
02
2022
revised:
21
04
2022
accepted:
25
04
2022
entrez:
17
10
2022
pubmed:
18
10
2022
medline:
18
10
2022
Statut:
ppublish
Résumé
The Indian Health Service (IHS) and Tribal health programs provide clinical pharmacy services to improve health outcomes among American Indian and Alaska Native (AI/AN) adults with cardiovascular disease (CVD). The study's primary objective was to describe characteristics, including social determinants of health (SDOH), associated with clinical pharmacy utilization by AI/ANs with CVD who accessed IHS/Tribal services. A secondary objective assessed changes in systolic blood pressure (SBP) associated with such utilization. Analysis included IHS data for 9844 adults aged 18 and older with CVD who lived in 5 locations. Multivariable logistic regression was used to examine patient characteristics (eg, age, sex, health status, SDOH) associated with clinical pharmacy utilization in fiscal year (FY) 2012. A propensity score model was employed to estimate the association of elevated SBP in FY2013 with FY2012 clinical pharmacy utilization. Nearly 15% of adults with CVD used clinical pharmacy services. Among adults with CVD, the odds of clinical pharmacy use were higher among adults diagnosed with congestive heart failure (adjusted odds ratio [OR] = 1.22; 95% CI:1.01-1.47), other types of heart disease not including ischemia (OR = 1.40; 95% CI: 1.18-1.65), and vascular disease (OR = 1.23; 95% CI: 1.04-1.46), compared to adults without these conditions. Diabetes (OR = 4.05, 95% CI: 3.29-5.00) and anticoagulation medication use (OR = 20.88, 95% CI: 16.76-20.61) were associated with substantially higher odds of clinical pharmacy utilization. Medicaid coverage (OR = 0.72; 95% CI: 0.56-0.93) and longer travel times to services (OR = 0.87; 95% CI: 0.83-0.92) were each associated with lower odds. FY2012 clinical pharmacy users had lower odds of elevated SBP (OR = 0.71 95% CI: 0.58-0.87) in FY2013 than nonusers. In addition to health status, SDOH (eg, Medicaid coverage, longer travel times) influenced clinical pharmacy utilization. Understanding characteristics associated with clinical pharmacy utilization may assist IHS/Tribal health programs in efforts to support optimization of these services.
Identifiants
pubmed: 36246030
doi: 10.1002/jac5.1651
pii: JAC51651
pmc: PMC9544095
doi:
Types de publication
Journal Article
Langues
eng
Pagination
800-811Subventions
Organisme : NIA NIH HHS
ID : R01 AG061189
Pays : United States
Organisme : NIDDK NIH HHS
ID : R18 DK114757
Pays : United States
Informations de copyright
© 2022 The Authors. JACCP: Journal of the American College of Clinical Pharmacy published by Wiley Periodicals LLC on behalf of Pharmacotherapy Publications, Inc.
Déclaration de conflit d'intérêts
The authors declare no potential conflict of interest.
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