VCU news

By Leah Small and Greg Weatherford

The VCU School of Pharmacy’s Center for Pharmacy Practice Innovation, in collaboration with VCU Health, is launching a project to help people across Virginia prevent diabetes and heart disease.

The five-year project, supported by a projected $1.3 million over five years from the Virginia Department of Health and the Centers for Disease Control and Prevention, will use telemedicine, remote monitoring, one-on-one coaching and community partnerships to improve participants’ health.

In the first phase, VCU School of Pharmacy faculty and students will work with participants with prediabetes at the soon to open VCU Health Hub at 25th in Richmond’s East End alongside dietitians and dietetic interns with VCU Health.

“Rather than requiring participants to travel to seek preventive and education services, this program will be in the community’s backyard,” said Dave Dixon, Pharm.D., director of the Center for Pharmacy Practice Innovation and vice chair for clinical services in the School of Pharmacy.

Participants in this first phase will learn strategies to help prevent type 2 diabetes. Lifestyle change in patients with prediabetes is an effective way to prevent progression to type 2 diabetes and subsequent serious health problems. The approximately 50 participants in the first year will be referred by community partners and health clinics.

“This kind of project demonstrates how we aspire to reshape care to better meet the needs of communities,” said Alan Dow, M.D., assistant vice president for interprofessional education and collaborative care in the VCU Office of the Vice President for Health Sciences. “It is innovative in how practitioners collaborate, how we train future practitioners, and how we use technology, all inspired by the needs of the people we serve.”

Prediabetes affects approximately 81 million adults in the United States and can lead to type 2 diabetes. In the U.S., diabetes has an estimated cost of $327 billion per year, according to the American Diabetes Association.

In future phases, the project will expand to other areas of Virginia and include monitoring and treatment of high blood pressure. Hypertension can damage organs and lead to death. It costs about $46 billion each year in health care services, medications and missed days of work in the U.S., according to the CDC.

The hypertension phase of the project will work with community pharmacies and the VCU Office of Telemedicine and use Bluetooth-enabled blood pressure devices to monitor and coach high-risk participants. VCU is exploring a collaboration with Virginia Premier to develop and implement a community pharmacy-based high blood pressure monitoring program.

"This grant provides an opportunity to build a model that is outside of the traditional health care setting and deploy the resources available through VCU's School of Pharmacy to support the growing number of individuals with diabetes, hypertension and heart disease,” said Sheryl Garland, chief of health impact for VCU Health System. “In collaboration with community partners, this program will introduce innovative prevention and wellness strategies that are critical to helping individuals live longer and manage their conditions better."

“Traditionally, health care has been organized around brick and mortar,” said Vimal Mishra, M.D., medical director of the Office of Telemedicine in VCU Health’s Division of Hospital Medicine.

“With virtual health care models and technologies such as remote patient monitoring, virtual visits and the use of mobile apps we have the opportunity to extend our specialist care beyond our walls, making it available throughout the commonwealth.”

Dixon and Teresa Salgado, Ph.D., will lead the VCU project as co-principal investigators with Sharon Gatewood, Pharm.D., and Evan Sisson, Pharm.D., as co-investigators.

Highlights of the program include:

• Diabetes prevention education: Participants will take part in a 16-week program from the CDC that is shown to reduce the risk of type 2 diabetes by 50 percent. School of Pharmacy faculty and dietitians from the VCU Health System Dietetic Internship will lead the classes.
• E-referral pathway: The program will partner with community pharmacies, health clinics and other community organizations to create referral mechanisms using electronic health records to identify participants and monitor their progress.
• Remote blood pressure monitoring: Participants will use Bluetooth-enabled blood pressure devices, provided by the VCU Office of Telemedicine, which can send data to local community pharmacies where pharmacists will monitor and coach participants on medication adherence and lifestyle changes to improve blood pressure control.  
• Provider training: In collaboration with the Virginia Pharmacists Association, School of Pharmacy faculty will provide training using the Pharmacy-Based Cardiovascular Disease Risk Management course created by the American Pharmacists Association.