Fluent Essays

According to the Center for Disease Control and Prevention, cardiovascular disease (CVD) is the leading cause of deaths in the United States, equating to about 1 in every 4 deaths. In 2018, the CDC published updated best practice strategies to help decrease cardiovascular disease risks. Initial Post · View Best Practices for Cardiovascular Disease Prevention Programs.  · On this website, select one of the best practice strategies. Within each practice strategy, you will find three tabs: evidence of effectiveness, evidence of impact, and implementation considerations. In your initial post, use these key categories to address the following question: · How effective is this practice? · What kind of impact does this practice have? · What are the top considerations in implementing this strategy in your community? Be sure to support your positions with APA formatted in-text citations and references from the assigned Section B Module 02 Content 1.   Top of Form After reviewing and studying this module’s content, answer the following questions. Be sure to complete all lab activities and attend/watch all live lectures before completing this assignment. All of your answers should be written in your own words, using full sentences, correct terminology, and proper spelling and grammar. 1. Explain the anatomical concepts associated with the heart. Summarize this module’s key points in 5-6 sentences. 2. Explain the physiological concepts associated with the heart. Summarize this module’s key points in 5-6 sentences. 3. How will you apply the concepts you have learned about the heart in real life and in your future career? Best Practices for Cardiovascular Disease Prevention Programs The Best Practices Guide for CVD Prevention describes and summarizes scientific evidence behind 8 effective strategies for lowering high blood pressure and cholesterol levels that can be implemented in health care systems and that involve community-clinical links. The guide is a resource for state and local health departments, decision makers, public health professionals, and other stakeholders interested in using proven strategies to improve cardiovascular health.  Learn more about the guide . The 8 strategies that are highlighted in this guide were carefully reviewed and selected through a process that is described in the full PDF version of the Best Practices Guide for CVD Prevention Programs. Best Practice Strategies Learn more about the evidence behind these 8 best practice strategies and find resources and tools to help with implementation in the links below. Download the guide Cdc-pdf[PDF-5 MB] Team-Based Care Learn how using a team-based care model can improve hypertension control. More Collaborative Practice Agreements Learn how collaborative practice agreements between pharmacists and providers can improve patient care. More Self-Measured Blood Pressure Learn how this strategy can improve blood pressure control at home. More Self-Management and Education Find out how you can empower patients to take steps to reduce risks and manage chronic disease. More Reducing Medication Costs Learn how lowering costs can eliminate barriers between patients and the medications they need. More Clinical Decision Support Find out how point-of-care prompts support providers in following clinical guidelines. More Community Health Workers Learn how to engage CHWs as members of the care team in the community. More Medication Therapy Management Learn about the expanding role pharmacists play in patient care and education. More Implementing Clinical Decision Support Systems Download the strategy pdf icon[PDF - 660 KB]. Clinical decision support systems (CDSS) are computer-based programs that analyze data within EHRs to provide prompts and reminders to assist health care providers in implementing evidence-based clinical guidelines at the point of care. Applied to cardiovascular disease (CVD) prevention, this  Domain 3  strategy can be used to facilitate care in various ways—for example, by reminding providers to screen for CVD risk factors, flagging cases of hypertension or hyperlipidemia, providing information on treatment protocols, prompting questions on medication adherence, and providing tailored recommendations for health behavior changes. · Evidence of Effectiveness · Evidence of Impact · Implementation Considerations The evidence base demonstrating the effectiveness of CDSS is very strong. Research studies that examined CDSS had strong internal and external validity, the Community Preventive Services Task Force concluded that CDSS is effective, and CDSS trials have been replicated with positive results. Implementation guidance on CDSS is available from several sources. CDSS at South Omaha Medical Associates South Omaha Medical Associates (SOMA) is a family-owned, family-operated clinic that is centrally located in South Omaha, Nebraska. It has a higher percentage of low-income patients than clinics in surrounding areas. SOMA collaborated with the Nebraska Department of Health and Human Services, Douglas County Health Department, and Wide River Health Information Technology to assess its technology needs and make plans to implement CDSS. As a result of this assessment, the clinic increased its use of EHRs and implemented systems to better identify patients with undiagnosed hypertension, increase use and monitoring of clinical quality measures, and increase use of clinically supported self-measured blood pressure monitoring. These changes improved workflow at the clinic and led to a 25\% increase in patient visits since the start of the collaboration. In addition, Blue Cross Blue Shield awarded SOMA its Blue Distinction Award for meeting overall quality measures for patient safety and outcomes. For more information: Chronic Disease Prevention and Control Program Nebraska Department of Health and Human Services 301 Centennial Mall South Lincoln, NE 68509 Email:  [email protected] References 1. Community Preventive Services Task Force. The Guide to Community Preventive Services. Cardiovascular Disease: Clinical Decision-Support Systems (CDSS).  https://www.thecommunityguide.org/findings/cardiovascular-disease-clinical-decision-support-systems-cdssexternal icon . Accessed August 17, 2017. 2. Njie GJ, Proia KK, Thota AB, et al. Clinical decision support systems and prevention: a Community Guide cardiovascular disease systematic review. Am J Prev Med. 2015;49(5): 784–795. 3. NORC at the University of Chicago. Understanding the Impact of Health IT in Underserved Communities and Those with Health Disparities.  https://www.healthit.gov/sites/default/files/pdf/hit-underserved-communities-health-disparities.pdf pdf icon[PDF-929 KB]external icon . Accessed February 9, 2017. 4. Mitchell J, Probst J, Brock-Martin A, Bennett K, Glover S, Hardin J. Association between clinical decision support system use and rural quality disparities in the treatment of pneumonia. J Rural Health. 2014;30(2):186–195. 5. Jacob V, Thota AB, Chattopadhyay SK, et al. Cost and economic benefit of clinical decision support systems for cardiovascular disease prevention: a Community Guide systematic review. J Am Med Inform Assoc. 2017;24(3): 669–676. 6. American Medical Group Foundation. Measure Up Pressure Down: Provider Toolkit to Improve Hypertension Control. Alexandria, VA: American Medical Group Foundation; 2013. 7. Optimizing Strategies for Clinical Decision Support.  https://www.healthit.gov/sites/default/files/page/2018-04/Optimizing_Strategies_508.pdf pdf icon[PDF – 1.4 MB]external icon . Accessed June 24, 2020 8. Kilsdonk E, Peute LW, Jaspers MWM. Factors influencing implementation success of guideline-based clinical decision support systems: A systematic review and gaps analysis. International Journal of Medical Informatics. 2017;98:56-64. 9. Centers for Disease Control and Prevention. Hypertension Control Change Package for Clinicians. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services; 2015. 10. gov. Policymaking, Regulation, & Strategy. Clinical Decision Support (CDS).  https://www.healthit.gov/policy-researchers-implementers/clinical-decision-support-cdsexternal icon . Accessed April 12, 2017. 11. Merit-Based Incentive Payment System: Advancing Care Information. https://qpp.cms.gov/mips/advancing-care-information. Accessed September 26, 2017. 12. Agency for Healthcare Research and Quality. Health Information Technology. Clinical Decision Support (CDS).  https://healthit.ahrq.gov/ahrq-funded-projects/clinical-decision-support-cdsexternal icon . Accessed April 12, 2017. 13. Fox J, Thomson R. Clinical decision support systems: a discussion of quality, safety and legal liability issues. Proc AMIA Symp. 2002:265–269. 14. Norwegian Institute of Public Health. GUIDES checklist: A tool to assist professionals when implementing guidelines with computerized decision support.  https://www.guidesproject.org/external icon . Accessed March 22, 2018. Note: The web version has been updated in an effort to keep the linked resources current, and for this reason some of the content may differ with the PDF version. Community Pharmacists and Medication Therapy Management Download the strategy pdf icon[PDF - 775 KB]. Medication therapy management (MTM) is a distinct service or group of services provided by health care providers, including pharmacists, to ensure the best therapeutic outcomes for patients. MTM includes five core elements: medication therapy review, a personal medication record, a medication-related action plan, intervention or referral, and documentation and follow-up. Within the context of cardiovascular disease (CVD) prevention, MTM can include a broad range of services, often centering on the following: · Identifying uncontrolled hypertension · Educating patients on CVD and medication therapies · Advising patients on health behaviors and lifestyle modifications for better health outcomes MTM is especially effective for patients with multiple chronic conditions, complex medication therapies, high prescription costs, and multiple prescribers. MTM can be performed by pharmacists with or without a collaborative practice agreement (CPA), and it is a strategy that can be considered to straddle  Domain 3  (health care system interventions) and  Domain 4  (community-clinical links). · Evidence of Effectiveness · Evidence of Impact · Implementation Considerations Strong evidence exists that the use of MTM by pharmacists is effective. Although the exact combination of MTM activities tends to vary between settings, studies examining MTM have generally found it to be effective and to have strong internal and external validity. MTM trials have been replicated in many different contexts with positive results. Implementation guidance on MTM is available from several sources, including the guidance provided under Medicare Part D. MTM at Ohio Department of Health In 2014, the Ohio Department of Health (ODH) teamed up with three Federally Qualified Health Center (FQHC) sites to assess the effect of MTM counseling sessions on patients with hypertension. This effort involved collaboration among the Ohio State University College of Pharmacy, Ohio Pharmacists Association, Ohio Association of Community Health Centers, and the Health Services Advisory Group. These partners helped plan and develop the assessment. Pharmacists administered MTM to 500 patients with hypertension who were receiving care at one of the three FQHC sites. After 6 months, assessments found that hypertension control had increased to 68.6\% among these patients. There were key components related to the project’s achievement, which included maintaining relevant partnerships, implementing the pilot in one type of pharmacy setting, allowing FQHC sites to develop their own protocols for patient enrollment, using effective dissemination processes, and selecting data points that align with current pharmacy practices. Challenges included finding champions for the MTM model. For more information: Jen Rodis, Assistant Dean for Outreach and Engagement Ohio State University College of Pharmacy Email:  [email protected] Website:  www.ohiochc.orgexternal icon References 1. Viswanathan M, Kahwati L, Golin C, et al. Medication therapy management interventions in outpatient settings. JAMA Intern Med. 2015;175(1):76–87. 2. Theising KM, Fritschle TL, Scholfield AM, Hicks EL, Schymik ML. Implementation and clinical outcomes of an employer-sponsored, pharmacist-provided medication therapy management program. Pharmacotherapy. 2015;35(11):e159–e163. 3. Tsuyuki RT, Johnson JA, Teo KK, et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162(10):1149–1155. 4. Carter BL, Barnette DJ, Chrischilles E, Mazzotti GJ, Asali ZJ. Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting. 1997;17(6):1274–1285. 5. Chabot I, Moisan J, Grégoire J-P, Milot A. Pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003;37(9):1186–1193. 6. Cheema E, Sutcliffe P, Singer DRJ. The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials. Br J Clin Pharmacol. 2014;78(6):1238–1247. 7. Santschi V, Chiolero A, Colosimo AL, et al. Improving blood pressure control through pharmacist interventions: a meta-analysis of randomized controlled trials. J Am Heart Ass. 2014;3(2). 8. Ryan R, Santesso N, Lowe D, et al. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database Syst Rev. 2014(4):CD007768. 9. Isetts B, Schondelmeyer S, Artz M, et al. Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J Am Pharm Assoc. 2008;48:203–211. 10. Ramalho de Oliveira D, Brummel A, Miller D. Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm. 2010;16(3):185–195. 11. Wittayanukorn S, Westrick S, Hansen R, et al. Evaluation of medication therapy management services for patients with cardiovascular disease in a self-insured employer health plan. J Manag Care Pharm. 2013;19(5):385–395. 12. Centers for Medicare & Medicaid Services. Medication Therapy Management.  https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/MTM.htmlexternal icon . Accessed February 21, 2017. 13. American Pharmacists Association. APhA MTM Central. Implementing MTM in Your Practice.  https://portal.pharmacist.com/mtmexternal icon . Accessed February 21, 2017. 14. Agency of Healthcare Research and Quality. Improving Medication Management for Older Adult Clients.  https://www.guideline.gov/ summaries/summary/37826/improving-medication-management-for-older-adult-clients?q=assisted+livingexternal icon . Accessed August 18, 2017. 15. Agency of Healthcare Research and Quality. Innovations in Medication Therapy Management.  https://innovations.ahrq.gov/issues/2015/02/18/innovations-medication-therapy-managementexternal icon . Accessed February 21, 2017. 16. Centers for Disease Control and Prevention. The 6|18 Initiative: Accelerating Evidence into Action.  https://www.cdc.gov/sixeighteen . Accessed February 1, 2017. 17. Million Hearts. Cardiovascular Health Medication Adherence: Action Steps for Public Health Practitioners. Atlanta, GA: Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services; 2016. Page last reviewed: August 27, 2021 Content source:  National Center for Chronic Disease Prevention and Health Promotion  ,  Division for Heart Disease and Stroke Prevention