Community Health Programs Improved Outcomes Among Black Patients

Community-based approaches to diabetes and cardiovascular disease (CVD) management were found to improve health outcomes in predominantly Black communities, according to a study published in the Journal of the American Pharmacists Association.¹

“Improved access to evidence-based chronic disease prevention and management programs, as well as increased access to affordable and nutritious food and safe spaces for exercise are critical in underserved communities,” wrote authors of the study. “Research suggests that pharmacists are the most accessible and frequently visited members of the health care team, and therefore essential in prevention and optimizing management of patients with chronic disease.”

With many concerted efforts to improve health care initiatives in low- and middle-income communities, pharmacists have established themselves as key providers to manage community-wide patient outcomes. According to a study published in Exploratory Research in Clinical and Social Pharmacy, clinical evidence supports the pharmacist’s ability to improve economic, clinical, and humanistic outcomes through chronic disease management.² 

Researchers explored pharmacists’ abilities in a low-income community-focused program for improving diabetes and CVD outcomes among a majority of Black patients. | image credit: Dzmitry / stock.adobe.com

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Despite the expanding evidence of pharmacists’ crucial role in disease management, however, they are still significantly under recognized as primary care providers in today’s health care landscape. With reports of a notable disconnect between patients and pharmacists,³ despite their sheer accessibility compared with other providers, experts are looking for alternative ways to properly employ pharmacists within an integrated chronic disease management team.²

In the current study, researchers explored pharmacists’ abilities in a low-income community-focused program for improving diabetes and CVD outcomes among a majority of Black patients.

“The Prescription for Change (Rx for Change) program is a multifaceted, pharmacist-led, program created by Duquesne University's Center for Integrative Health (DUCIH), Center for Pharmacy Care (CPC), and School of Pharmacy as a response to the health disparities and high burden of chronic disease among the African American community in Pittsburgh,” they continued.¹ “This pilot study hypothesizes that accessible, well-coordinated and integrative approaches to diabetes and CVD prevention and management through [community-clinical linkages] will improve health outcomes in African American communities.”

To bolster evidence regarding pharmacists’ chronic disease prevention and management, researchers explored results from the Rx for Change pilot study, hypothesizing that the program would make a significantly positive impact on the Black community members of Pittsburgh’s Allegheny County.

Researchers recruited study participants from March 2021 to March 2022 and only enrolled patients that were 18 years or older; screened positive for pre-diabetes, diabetes, and/or hypertension; were Medicaid or Medicare recipients; and resided in one of the 4 included Allegheny County zip codes.

Those participating in the Rx for Change program experienced quarterly visits with a pharmacist, enrollment in chronic disease prevention and management programs, and support to implement a variety of pharmacist-led recommendations. All of these actions required of study participants occurred during a 1-year study period. Researchers examined differences in demographics, clinical characteristics, program referrals, and overall participation of the study’s patients compared with baseline data.

The pilot study program included a total of 52 participants (average age, 60.7 years; 82.7% women; 71.2% Black). Regarding previously recorded chronic disease instances, around 33% reported previously diagnosed type 2 diabetes, 17.3% had pre-diabetes, and 51.9% had hypertension.

“The community-based implementation approach supported engagement of the target population,” wrote the authors.¹ “Overall, patient engagement with the Rx for Change Program was excellent, with 82.7% of participants attending ≥ 60% of their scheduled quarterly visits with a pharmacist.”

Throughout the study year, a majority of participants attended at least 60% of their quarterly pharmacist visits, highlighting patients’ desires to seek chronic disease management to improve their diabetes and CVD outcomes. They also discovered improved A_1c outcomes among pilot participants, demonstrating reductions at 3-month intervals throughout the year. Finally, touching on overall satisfaction among participants, 28 completed the program satisfaction survey, with around 66% stating they planned to work with a pharmacist further to improve their overall health.

Amid significantly well-established support for pharmacists’ clinical roles, the results of this pilot study only confirm pharmacists’ abilities to manage chronic diseases and improve patient outcomes, particularly in low-income and underserved communities. While initiatives like this can significantly benefit Black communities, experts are looking to increase efforts like this to benefit patients of all communities by expanding pharmacy services, and more importantly, increasing overall patient access.

“Results from this study show that community-based and well-coordinated, integrative approaches to diabetes and CVD prevention and management can improve health outcomes in predominantly Black communities,” they concluded.¹ “More research is needed to enhance the nutrition intervention, evaluate in-person vs virtual delivery of education programs, and evaluate similar interventions with larger sample sizes to enhance generalizability.”

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References

1. Schoen RR, Hatcher T, Ripper L, et al. Rx for change: an integrative approach to community-clinical linkages and impact on health outcomes. JAPhA. 2025;65(6):102480. https://doi.org/10.1016/j.japh.2025.102480

2. Okoro RN, Nduaguba SO. Community pharmacists on the frontline in the chronic disease management: the need for primary healthcare policy reforms in low and middle income countries. Explor Res Clin Soc Pharm. 2021 Apr 13;2:100011. doi: 10.1016/j.rcsop.2021.100011.

3. Butler L, Zona S, Patel AA, et al. How can pharmacists better support patients with chronic diseases? the patient perspective. JAPhA. 2023;63(6):1776-1784.e3. https://doi.org/10.1016/j.japh.2023.08.023