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The program increased hypertension management rates to 77% in 2017.
The CDC is currently conducting investigations into a Michigan-based comprehensive hypertension control program to determine whether the setup has the potential for nationwide implementation.
According to the CDC, 1,332 patients with hypertension were served by Michigan Medicine clinic pharmacists in 2017, while an additional 514 were served in community pharmacies in three Meijer stores. Overall, the CDC reports that hypertension management control rates increased to 77% in 2017, up 5% from the previous recording in 2016.
The achievement of these statistics is attributed to the implementation of the five-step Pharmacist’s Patient Care Process, as well as to blood pressure alerts that ensure all patients with hypertension are referred to a pharmacist; allowing pharmacists to initiate, modify, and discontinue medication therapies and adjust dosages; developing onboarding protocols for clinic and Meijer pharmacists, including practice guidelines, shadowing experiences, and an EMR system training; and maintaining leadership support that provides administrative oversight, including hiring and training new pharmacists, overseeing quality control.
The program originated at the Michigan Medicine, the clinical care facility formerly known as the University of Michigan Health System, one of the largest healthcare systems in the state. Michigan Medicine provides preventive and acute health care services to diverse populations across southeastern Michigan and has recently expanded the use of its ambulatory services to three Meijer community pharmacy locations in Washtenaw County.
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The University of Michigan established its ambulatory care program in 1999. For the past 20 years, the program has steadily grown. The most notable achievement was in 2010 when it included 11 clinical care pharmacists, two post graduates, and two pharmacy residents operating across the health system’s 14 primary clinical care settings. The partnership between Michigan Medicine and Meijer community pharmacies was announced in 2016 and incorporated two community pharmacy locations at the time. By 2017, the clinical care settings were fully funding the operations of the pharmacists, and by 2018 the program expanded to a third Meijer location.
Merging into these community pharmacies allows Michigan Medicine to provide additional opportunities for patients to receive care that may better align with their schedules or comfort levels.
In 2009, when pharmacists were being introduced to the clinical care setting, they were merely working alongside physicians to focus on medication management for hypertension and other conditions; now, they are gaining a more direct involvement with patient care. For instance, pharmacists working in the Meijer community pharmacies are granted access to the patients’ medical records and authorized to make changes and updates, ensuring that pharmacists and physicians are always up-to-date on patient care.