In:
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY, Wiley, Vol. 5, No. 8 ( 2022-08), p. 800-811
Abstract:
The Indian Health Service (IHS) and Tribal health programs provide clinical pharmacy services to improve health outcomes among American Indian and Alaska Native (AI/AN) adults with cardiovascular disease (CVD). Objectives The study's primary objective was to describe characteristics, including social determinants of health (SDOH), associated with clinical pharmacy utilization by AI/ANs with CVD who accessed IHS/Tribal services. A secondary objective assessed changes in systolic blood pressure (SBP) associated with such utilization. Methods Analysis included IHS data for 9844 adults aged 18 and older with CVD who lived in 5 locations. Multivariable logistic regression was used to examine patient characteristics (eg, age, sex, health status, SDOH) associated with clinical pharmacy utilization in fiscal year (FY) 2012. A propensity score model was employed to estimate the association of elevated SBP in FY2013 with FY2012 clinical pharmacy utilization. Results Nearly 15% of adults with CVD used clinical pharmacy services. Among adults with CVD, the odds of clinical pharmacy use were higher among adults diagnosed with congestive heart failure (adjusted odds ratio [OR] = 1.22; 95% CI:1.01‐1.47), other types of heart disease not including ischemia (OR = 1.40; 95% CI: 1.18‐1.65), and vascular disease (OR = 1.23; 95% CI: 1.04‐1.46), compared to adults without these conditions. Diabetes (OR = 4.05, 95% CI: 3.29‐5.00) and anticoagulation medication use (OR = 20.88, 95% CI: 16.76‐20.61) were associated with substantially higher odds of clinical pharmacy utilization. Medicaid coverage (OR = 0.72; 95% CI: 0.56‐0.93) and longer travel times to services (OR = 0.87; 95% CI: 0.83‐0.92) were each associated with lower odds. FY2012 clinical pharmacy users had lower odds of elevated SBP (OR = 0.71 95% CI: 0.58‐0.87) in FY2013 than nonusers. Conclusion In addition to health status, SDOH (eg, Medicaid coverage, longer travel times) influenced clinical pharmacy utilization. Understanding characteristics associated with clinical pharmacy utilization may assist IHS/Tribal health programs in efforts to support optimization of these services.
Type of Medium:
Online Resource
ISSN:
2574-9870
,
2574-9870
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2920371-5
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