VCU news

By Anne Dreyfuss
C. Kenneth and Dianne Wright Center for Clinical and Translational Research

A Virginia Commonwealth University and Carilion Clinic co-led medication therapy and chronic disease state management program has reaped estimated cost savings of $1.2 million during its first 14 months, according to interim results presented at the 2014 American College of Clinical Pharmacy annual meeting. The program deployed pharmacists to primary care practices in an effort to better assist chronically ill patients after being discharged from the hospital or referred by their physician.  

The estimated savings are based primarily on reduced health services utilization including doctor visits, emergency department use and hospitalizations. Other indicators of success include reductions in blood pressure and improved diabetes control for patients enrolled in the program.

Improving Health for At-Risk Rural Patients is funded through a three-year $4.16 million grant from the Centers for Medicare and Medicaid Services Innovation Center to Carilion New River Valley Medical Center. It began by enrolling patients in a rural and medically underserved region of Southwestern Virginia in January 2013. The goal of the program is to improve medication therapy use and chronic disease state outcomes through regular interactions between patients and pharmacists in primary care clinics and community pharmacies. Ultimately, the aim is to improve health and reduce hospitalization, emergency room visits and adverse drug events in patients with multiple chronic diseases.

“It moves pharmacists from a traditional role that people might see in the community to primary care practices,” said Gary Matzke, Pharm.D., professor and director of practice transformation initiatives at the VCU School of Pharmacy. Matzke is co-principal investigator on the project that operates in 22 Carilion Clinic primary care clinics and six Carilion hospitals. Leticia Moczygemba, Pharm.D., Ph.D., assistant professor at the VCU School of Pharmacy, leads the evaluation team for the project. William Lee, Carilion Clinic System pharmacy director, is the program’s principal investigator.  

One of the first programs aimed at bridging the gap between hospital and outpatient clinicians, the purpose of the grant was to coordinate the communication of medication-related concerns to the patients’ primary care provider to follow up after discharge. It was also to connect the in-patient pharmacist with the primary care clinic team, which includes pharmacists, doctors and nurses as well as the patient’s community pharmacist.

“The project’s interim results indicate that an interprofessional team-based care approach is an important improvement over usual primary care,” Matzke said.

As of late November, the IHARP program had enrolled more than 2,600 patients and is on schedule to achieve a total enrollment goal of about 2,700 by the end of the year.  

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