Travel Time, Income May Deter Clinical Pharmacy Use by AI/AN Adults With CVD

Health status and social determinants of health among American Indian and Alaska Native (AI/AN) adults with cardiovascular disease (CVD) influenced the use of clinical pharmacy services provided by the Indian Health Service and Tribal health programs, according to a study published in the Journal of the American College of Clinical Pharmacy.

“Study results indicate that some AI/AN adults with CVD who may benefit from clinical pharmacy utilization may not access such services due to barriers related to travel time, household income, or other factors influencing service use,” wrote corresponding author Joan O'Connell, PhD, of the Centers for American Indian and Alaska Native Health at the University of Colorado, and coauthors. “Increased patient knowledge of these services and patient care coordination may facilitate their use of clinical pharmacy services and, ultimately, optimize their care and improve health outcomes.”

The study included 9844 AI/AN adults with CVD from 5 locations. Among them, 15% used clinical pharmacy services.

The likelihood of clinical pharmacy use was higher among adults with congestive heart failure (the study reported a 1.22 adjusted odds ratio), other types of heart disease not including ischemia (1.40 odds ratio), and vascular disease (1.23 odds ratio). Substantially higher odds of clinical pharmacy utilization occurred with diabetes (4.05 odds ratio) and anticoagulation medication use (20.88 odds ratio), according to the study.

On the flip side, the likelihood of clinical pharmacy use was lower with Medicaid coverage (0.72 odds ratio) and longer travel times to services (0.87 odds ratio).

Those who used clinical pharmacy services had lower odds of elevated systolic blood pressure the next year, the study found.

“Adults with CVD who used clinical pharmacy services in FY2012, compared to nonusers, were 29% less likely to have elevated systolic blood pressure in FY2013,” researchers reported.

Reference:
O'Connell J, Grau L, Manson SM, et al. Use of clinical pharmacy services by American Indians and Alaska Native adults with cardiovascular disease. J Am Coll Clin Pharm. 2022;5(8):800-811. doi:10.1002/jac5.1651