Outcomes of the Pharmacist and Community Health Worker Heart Healthy Clinic Model

Abstract

Background: Pharmacist-led interventions have demonstrated success in managing cardiovascular risk factors; addressing social drivers of health (SDOH) is essential to improving health outcomes. Community health workers (CHWs) can help overcome SDOH barriers and enhance care delivery. Little research exists on pharmacist-CHW collaborations, particularly in free clinics. Objectives: The objectives of this study were to characterize the infrastructure of a pharmacist-CHW managed cardiovascular clinic model and assess whether systolic (SBP) and diastolic blood pressure (DBP) changed over time. Methods: The Pharmacists' Patient Care Process characterized the model infrastructure aligning pharmacist and CHW roles. This single-center, retrospective study evaluated patients with hypertension engaged in pharmacist-CHW services between February 1, 2023 and September 4, 2024. Data included demographics, as well as clinical and SDOH outcomes. A Linear Mixed Effects Model (LMEM) assessed the relationship between predictor variables, time, and their interaction. Multivariable analysis using LMM included predictors while excluding variables with multicollinearity or limited data. Results: Data were analyzed for 53 unique patients across 231 visits. SBP and DBP decreased significantly over time, with a predicted mean reduction of 9.63 and 7.57 mmHg, respectively (β = −9.63, p = 0.002 and β = −7.57, p < 0.001, respectively). Individuals who had three or more identified medication therapy problems (MTPs) had a significantly higher SBP (β = 19.10, p = 0.001) and DBP (β = 9.60, p = 0.015) than individuals who had no MTPs identified. The CHW provided 100 referrals, often for medical services beyond the scope of the free clinic. Conclusion: This study highlights the effectiveness of a pharmacist-CHW cardiovascular clinic model in significantly improving blood pressure outcomes over time. The findings demonstrate the potential to integrate CHWs and address SDOH, ultimately enhancing care delivery for diverse populations. Future research should explore the model's scalability, economic impact, and effectiveness in managing other chronic conditions.