Researchers from the University of Tennessee Health Science Center (UTHSC), led by Satya Surbhi, PhD, assistant professor in the Center for Health System Improvement in the College of Medicine, have received a $3.5 million grant from the National Institute on Minority Health and Health Disparities (NIMHD) for a study addressing system-level barriers to improve medication adherence among socioeconomically disadvantaged populations in Tennessee.
The Medication Affordability, Accessibility, and Availability in Care Transitions (Med AAAction) Study is a pharmacy-led care transitions intervention. It involves 388 Medicaid and uninsured hospital inpatients with multiple chronic conditions from three large Tennessee non-profit health care systems including Regional One Health in Memphis, the University of Tennessee Medical Center in Knoxville, and Ballad Health Johnson City Medical Center in Johnson City. Inpatients will be provided free medications, medication delivery, and care coordination to improve health outcomes and patient experience. These interventions will be tested for their effectiveness in improving medication adherence and reducing hospitalizations, emergency department use, and costs among socioeconomically disadvantaged populations.
“Vulnerable patients experience major gaps in care after transitions from hospital to community setting,” said Dr. Surbhi, who is also director of measurement and reporting for the Tennessee Population Health Consortium. “Thus, my long-term goal is to demonstrate the effectiveness of a care transitions adherence intervention model for vulnerable populations that can be readily adopted and sustained by health care delivery systems across the U.S.”
Patients in the intervention group will receive medications with zero copay, bedside and home delivery of medications, and care coordination provided by certified pharmacy technicians/health coaches. The pharmacy technicians and health coaches will assist with medication access, medication reconciliation, and rapid and ongoing primary care follow-up after hospital discharge. The study will provide valuable results to help health systems, payers, and policymakers achieve a triple aim – improving health outcomes and patient experience, and reducing costs among socioeconomically disadvantaged populations. The study findings will be generalizable to low-income individuals with multiple chronic conditions and to health systems serving them. Further, the findings may potentially drive significant changes in future health care delivery and policy for vulnerable populations.
Dr. Surbhi’s co-investigators at UTHSC are Jim Bailey, MD, MPH, the Robert S. Pearce endowed chair in Internal Medicine, professor of Medicine and Preventive Medicine, and director of the Tennessee Population Health Consortium; Betsy Tolley, PhD, professor, and Cori Grant, PhD, assistant professor, both in the department of Preventive Medicine; Susan Butterworth, PhD, associate professor of Medicine; Csaba Kovesdy, MD, director of the Clinical Outcomes and Clinical Trials Program in Nephrology at UTHSC and chief of the Nephrology Section at the Lt. Col. Luke Weathers, Jr. VA Medical Center (formerly the VA Medical Center) in Memphis; and Shaunta Chamberlin, PharmD, professor of Family Medicine at the UTHSC College of Medicine in Knoxville.
“The Department of Family Medicine and the pharmacy team at UT Medical Center Knoxville are excited to participate in this project with the leadership of Dr. Kim Mason, director of Pharmacy at the UT Medical Center,” Dr. Chamberlin said. “We feel this project has the potential to improve access and care for many of our patients and look forward to working with Dr. Surbhi and the research group.”
Co-investigators from other institutions on the study are KariLynn Dowling-McClay, PharmD, MPH, BCACP, assistant professor of Pharmacy Practice and director of the Academic Pharmacy Fellowship in the Bill Gatton College of Pharmacy at East Tennessee State University (ETSU); Hadii Mamudu, PhD, professor in the College of Public Health at ETSU; and Cameron Kaplan, PhD, associate professor of Medicine and director of the Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California.
“The days following a hospital discharge are a high-risk time when people are still in recovery, trying to manage new treatment plans, and facing many expenses and other challenges,” Dr. Dowling-McClay said. “It is vital that we find new ways of providing care for individuals with limited resources to help them best manage their chronic diseases and avoid rehospitalization. Pharmacy teams are well-positioned in our communities to assist with bridging these gaps in care.”
“By integrating innovative solutions to address systemic barriers, we’re not only improving individual patient experiences but also potentially leading to savings from avoidable costs related to non-adherence,” Dr. Kaplan said.