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Addressing Needs to Improve the Care of South Dakotans with Diabetes, Heart Disease, and Stroke through CDC-1815: Year Two

Pharmacy customer service

Investigators from the College of Pharmacy and Allied Health Professions at SDSU are engaged in a five-year project, prompted by a call-to-action from the Centers for Disease Control and Prevention to develop solutions to improve the care of South Dakotans with diabetes, heart disease and stroke.

During the first year, the project team, led by Dr. Sharrel Pinto, interviewed patients, practitioners, and payers to identify current challenges to care in the state. Year one findings showed that more information on the role of the pharmacist and the positive effect of pharmacist services like medication therapy management (MTM) is needed.

In year two, the project team set out to recruit more participants and create educational materials to increase awareness and knowledge about pharmacist services and MTM. Surveys were also developed to track growth in awareness.

To accomplish this task, the project team developed three webinars, presented one PharmTalk, conducted nine APhA trainings, began development on a variety of educational materials including one commercial for the Your Pharmacist Knows campaign, presented six posters and began development on five papers over the course of year two.

Additional activities were planned, however year two presented some unique challenges with the arrival of the COVID-19 pandemic, delaying some activities indefinitely. The project team responded positively, however, moving some activities online and otherwise adapting to the unique circumstances. In the end, year two goals and objectives were achieved despite the pandemic.

The project team also adapted and grew to meet the growing needs of the project. Dr. Yen Ming Huang, Dr. Deidra Van Gilder, Dr. Aaron Hunt and Dr. Erin Miller were added to the project as co-investigators, joining Dr. Alex Middendorf.

The project and team were also divided into three workgroups: the patient workgroup, the practitioner workgroup, and the payer workgroup, respective of the three types of participants interviewed in Year One. Dr. Huang led the patient workgroup, Drs. Middendorf and Van Gilder led the practitioner workgroup, and Dr. Hunt led the Payer workgroup, while Dr. Miller assisted with all three. Dr. Pinto, as principal investigator, oversaw the work of all three workgroups.

Major Needs Identified in Year One and Actions the Team took to Address Them in Year Two
Year One: Identified NeedsYear Two: Addressing Needs
Non-pharmacist practitioners needed more education on pharmacist expertise and servicesFocused educational efforts, such as a development of a webinar, geared toward educating non-pharmacist practitioners on pharmacist background, expertise and services for patients
Pharmacists expressed a desire to be a more integral part of the healthcare teamIn-depth conversations and strategies with partners to empower pharmacists and their administrators to integrate them into the patient healthcare journeys
Pharmacists needed guidance on integrating MTM services into workflowDevelopment of a webinar delving into MTM and its practical applications; advanced training for 27 SD pharmacists, including actions, templates, and workflow processes to help implement MTM immediately in their practice
Patients needed more understanding of services pharmacists provideDevelopment of a thorough patient awareness campaign that will help patients begin to familiarize themselves with these services
Payers understood team-based care but needed help in figuring out how to reimburse pharmacists for their servicesDevelopment of a toolkit that will provide detailed instructions, examples, and forms for payers to customize for their needs in reimbursing for pharmacy-based services

In year two, the patient workgroup developed the Your Pharmacist Knows campaign, to be launched in year three. The purpose of this campaign was to increase patient awareness of the various services their pharmacist can provide, including MTM. In addition to the creation of a variety of educational and promotional materials, including a 30-second commercial, investigators also recruited 211 participants to complete a survey to assess the effectiveness of the campaign.

Findings from these surveys, combined with findings from year one patient interviews, were used to begin development on a paper which will “showcase the preliminary findings of patient awareness and knowledge of pharmacists and their services as well as medication behavior.”

Meanwhile, the practitioner workgroup focused on creating educational materials and trainings for medical professionals. In response to findings from year one research, the project team developed three different webinars: one for pharmacists, one for non-pharmacist practitioners and one for SD Medicaid practitioners.

In addition to the webinars, the practitioner workgroup also worked with the American Public Health Association to facilitate training for fifteen South Dakota pharmacists on three topics: MTM, cardiovascular disease and diabetes. The training also certified and enabled these pharmacists to provide similar training to other pharmacists. The project team’s goal is to have 300 pharmacists trained by 2023.

The practitioner workgroup also began development on posters and papers for disseminating year one and two findings.

The goal of the payer workgroup was to develop materials to allow health plan providers to acquire more knowledge about pharmacists, the services they can provide, and reimbursement for those services. This goal was made in response to year one findings which revealed payers “did not fully understand what services pharmacists could provide and how they could assist in managing patients with cardiovascular disease and diabetes.”

To do so, the project team developed a brief summarizing year one findings to provide to payers. The team continued research on current payment models in order to bring participants up to date. The payer workgroup also had a poster presented at the annual APhA conference and began development on a paper.

The payer workgroup’s "major accomplishment" during year two was to expand relationships with key payers. This included developing further educational materials, signing NDAs and onboarding additional payers with plans to continue elicitation interviews with new partners in year three.

The project team also increased efforts to partner with tribal nations and organizations that serve American Indians, who represent approximately 10% of the state’s population.

Many year two activities were conducted in response to barriers identified during year one. Overall, the project team, with their three collaborating patient, practitioner, and payer workgroups, continued to develop and respond to their findings, despite challenges brought by the COVID-19 pandemic. At the end of year two, together they “strategically planned year three activities with the goal to continue advancing the adoption of pharmacist provided services.”



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