Pharmacists can host community events and try different marketing efforts to drive community awareness about heart health and total health.
Molly McGraw, PharmD, BCPS, manager of the Care Management Pharmacy Team at UMPC Health Plan in Pittsburgh, Pennsylvania, joins Pharmacy Times during American Heart Month to discuss the importance of holistic care for patients with heart conditions, and discusses the benefits of providing care as part of a multidisciplinary collaboration and engaging with the community to improve education and health outcomes.
PT Staff: Now, how can larger health systems such as yours drive community awareness and education about heart health, seeing that it is American Heart Month?
Molly McGraw, PharmD, BCPS: Yes, I think definitely trying to appeal to your population. We do this in a number of different ways. Community events are really big with us in terms of promoting all the things. So lifestyle, wellness, and medical aspects. We really make sure that we have the key personnel at the table to be able to talk specifically about all of those things as they're all equally important when it comes to a person's heart health. In addition to that, we really do a lot in the marketing realm as well. So whether that is digital, putting together some different podcasts on a specific topic— letters, or any type of outreach that we can do to really inform our member population— is key.
PT Staff: How can pharmacists improve local access to advanced care options for the management of heart disease and or associated morbidities?
Molly McGraw, PharmD, BCPS: I think access is key to all of this, even beyond heart health. Specifically at the health plan, the pharmacists here focus on access as a whole. We have a lot of programs that we telephonically reach out to members and to providers for, but beyond that, how can our members and our patients access us at the time that they need us?
We’ve really put some tools into place from the telehealth perspective. [Patients] could essentially sign up register for an appointment at a time that works well for them and engage 1-on-1 via video phone call with talking about their medications, asking questions, asking side effects questions, whether their provider put them on a new heart medication, and if they just need help working through some of that information.
PT Staff: I can imagine. From past interviews I've done with pharmacists, it seems like providers give you the medication and say “Okay, here are the top 2 adverse events,” and send you on your way.
Molly McGraw, PharmD, BCPS: Yes. So really having that full-service approach to say “Hey, we have a team of pharmacists here [and] we're here to talk to you about what questions you have.” Being an Individual Demographic Form (IDF) system, we do have some extra tools that we can utilize. We have access to EMR information [and] outpatient records, [and] that really can put all those puzzle pieces together to know the “why” behind why the provider may have chosen this medication over another, and really help to support that education as well.
PT Staff: Howcan communication between pharmacists, cardiologists and other health care providers impact patient medication adherence and outcomes?
Molly McGraw, PharmD, BCPS: Multidisciplinary approach is key, no matter where you're practicing as a pharmacist. Yes, we are the medication experts and know a lot when it comes to counseling in that area; how to support patients in that area. But having that full understanding from the multidisciplinary team is vital to be able to really treat a patient holistically.
Specifically within our programs, we utilize a multidisciplinary approach. I mentioned before we have access to the EMR— we can direct message providers, whether that's dieticians, whether that's social workers, whether that's physicians, [and] all are the key players in supporting a patient's heart health. So we can directly converse with them, send them messages, and work together as a team to optimize heart health for our members.
PT Staff: What can clinical pharmacists do to grow patient awareness about heart diseases, because prevention is also key, understanding why this happens…?
Molly McGraw, PharmD, BCPS: The first step is that the pharmacists are equipped with the knowledge themselves. So keeping ourselves up to speed on new guidelines that are published from American Heart Association (AHA) or other cardiac experts is key. Making sure we're up to speed on all of the updates, all of the guidelines, is important to be able to communicate and to educate our patients in our members.
That's the first thing that we do within our team, making sure we are up to speed. We're continuing education and all these important topics, but then also trying to relay that information to our patients so that they are equally educated about their disease states and about the importance of the medications and why their doctor chose to go this route for a blood pressure medicine or this route or controlling their heart rate— that sort of thing. It’s really just combining all of those educational efforts, [that] is key.
PT Staff: I feel like thecommon theme I've been hearing from you is [giving] the “why” to patients. Do you notice when patients have the why it impacts them a little differently in the way they approach the pharmacist or their medication?
Molly McGraw, PharmD, BCPS: Yes, it's definitely a known thing that shared decision making, putting the member first and making it a member-centered approach to guidelines, is extremely helpful. They [guidelines] are based on literature and they're based on outcome information; however, you do have to make decisions based upon what will work for that specific patient. So it really is at the crux of everything we do; making sure the member is on board with the decision and in the reason behind it. That's going to lead to them wanting to take the medication every day, wanting to go to cardiac rehab or [doing] whatever lifestyle or other entities [needed to] improve their heart health.
PT Staff: Thank you. What can health systems providers and pharmacists do to support mental health to among patients with heart conditions?
Molly McGraw, PharmD, BCPS: Well, we know patients with heart conditions often have mental health conditions as well. Specifically at the health plan, we have a lot of programs that utilize depression screenings [and] other anxiety related screenings to make sure that the member is coordinated through those care modules as well. Whether that is us putting some additional referrals into place to help support their mental health is going to be key because you do have to take a holistic approach when it comes to optimizing their heart health. You also have to optimize their mental health as well.
PT Staff: Do youthink that patients understand the impact of mental health? Or do you think that mental health is talked about enough in healthcare?
Molly McGraw, PharmD, BCPS: There's always room for improvement there. I do think we've made a lot of great a lot of great strides in the past few years (since the pandemic, actually) to really open that up a little bit more tap to open that comfort level. For us specifically, we know social risk factors are really big in terms of helping to optimize chronic conditions and helping to support their overall health outcomes. So as a pharmacist team, we've really encouraged our team to ask about social risk factors, social determinants of health (SDOH), as our segue and really ask it to 100% of the patients we're talking to across all of our programs— really open up that conversation. Because a lot of times we find there are barriers there— that patients are afraid to bring it up on their own—so as a provider, its being able to start that conversation and open that level of comfort. It is important to get that information from your patients.
PT Staff: That can be a big barrier for people who are seeking care. So what do you think (specifically in the realm of heart health and cardiac health) are some factors that need more consideration? What else needs to be done to improve SDOHs related to heart health?
Molly McGraw, PharmD, BCPS: It all goes back to access again; making sure that our patients have access to cardiology specialists, to different rehab facilities and different nutritional aspects, because all of that is equally important when it comes to optimizing heart health medications. So definitely providing and stabilizing and that sort of thing. But we're also looking for that holistic approach in terms of lifestyle— what foods what, what diet is happening. Really making sure that we are opening up access to all of those other areas beyond medications is equally important.
PT Staff: Has that been something that has changed for you over the years as a pharmacist?
Molly McGraw, PharmD, BCPS: I think so. You know, I initially started my role in in an acute care pharmacy setting. [I was] so ingrained on medications, medications, medications, but as I've grown as a provider [and] as a pharmacist, only looking at that silo of medications will only help you so far. Really looking, taking that holistic view, is going to be the best approach to ultimately effect those outcomes down the road.
PT Staff: What can local pharmacies do to bridge the gap between the patient and the pharmacist?
Molly McGraw, PharmD, BCPS: Making them accessible for questions so that patients feel comfortable seeing them as providers and you know, feeling comfortable asking them questions related to medications and that sort of thing. I know as a health plan, we're continually looking for opportunities to connect with our retail providers and partners to have them help us with some of our clinical programs and disease state programs that we’re conducting at the health plan and really trying to extend that reach into the retail network. Telephonic can get you so far [and] telehealth can get you so far, but those patients are going to the pharmacy to pick up those medications. They're often an extension as to what we're doing here at the health plan.
PT Staff: Do you want to add anything else?
Molly McGraw, PharmD, BCPS: I think it just goes back to that holistic view of the patient. You know, a lot of times these patients with heart conditions often have other comorbidities associated with those heart conditions. So having a robust program or a library of programs that will help support their diabetes— if they have diabetes, if they have renal disease, that sort of thing—and focusing attention on chronic condition management and optimizing their total health, not just that heart-related condition.
