Abstract Body: Background: Hypertension (HTN) control rates in the US remain suboptimal with long-standing racial and ethnic disparities in blood pressure control. Team-based care improves HTN outcomes and may advance equity by addressing social determinants, providing health education, and intensifying treatment equitably. Implementing an interprofessional model inclusive of community health care workers (CHWs) and pharmacists (PharmDs) to promote patient care poses challenges.
Objectives: To describe the experiences, lessons learned, and challenges with integrating CHWs and PharmDs into community health centers and primary care clinics.
Methods: We outline key lessons learned during the design and implementation of an ongoing cluster-randomized clinical trial; the “LINKED-HEARTS” (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS) Program. A total of 20 sites across 3 health systems in Maryland and Washington, D.C. were enrolled and randomized into either the intervention arm or enhanced usual care arm. Participants in the intervention arm received a multi-level intervention comprised of support of CHWs and a PharmD as well as utilization of home blood pressure monitoring and digital health technology to improve HTN control among adults with multiple chronic conditions.
Results: The LINKED-HEARTS Program has enrolled 336 participants (164 in the intervention arm).In total, 545 CHW visits and 458 PharmD visits occurred. To facilitate team-based care, the CHW and PharmD; 1) held bi-weekly meetings to review participant engagement, discuss concerns, as well as identify opportunities for support; and 2) conducted joint calls (39) with participants. The team identified clinic-based differences in community needs for support (transportation, medication, financial, etc) as well as workflow, documentation, and collaboration with providers.
Conclusion: CHWs and PharmDs are valuable health care workers who are underutilized in the clinic setting. Social determinants of health, provider training, and care clinic processes drive the implementation of team members.
Key lessons learned include: 1) CHWs and PharmDs must develop training sessions to better understand each other's roles; 2) The CHW-PharmD team should have an awareness of the needs of the communities they serve; 3) Consistency in training, processes, and communication with providers across various health sites must be established.