(1281) The Potential Public Health Impact of Pharmacists’ Patient Care Services for Heart Disease and Stroke Prevention: An Assessment of Evidence-informed State Policy Interventions

Objectives: This presentation will describe the rigorous and interdisciplinary process used to assess the evidence for five state policy interventions that seek to improve patient care through pharmacists’ patient care services. Findings from the assessment may inform state policies to support pharmacists in their efforts to promote health equity and improve population health. Pharmacists can reduce the risk of heart disease and stroke by providing patient care services and optimizing medication use. Evidence-informed policy interventions may support pharmacist-led efforts to improve chronic care, particularly for people experiencing health disparities. However, evidence to inform such policy interventions have not been assessed.

Methods: The Quality and Impact of Component Evidence (QuIC) assessment is a tool that, as part of a policy research continuum, assesses the strength and quality of the best available evidence for policy interventions. The QuIC assessment methodology uses five phases: 1) identifying the research question and policy interventions; 2) gathering and categorizing the evidence according to the policy intervention; 3) analyzing and coding the evidence bases for each policy intervention; 4) using the QuIC tool to score the policy interventions based on the quality of their evidence and the potential public health impact (including effectiveness, equity, reach, efficiency, and transferability); and 5) reporting the results in a policy evidence assessment report to inform how state policy could be scaled and benefit health outcomes.

We assessed the best available evidence for five policy interventions:1) pharmacist assesses patient’s needs & delivers tailored interventions, 2) pharmacist assesses patient’s needs & makes drug therapy recommendations to prescribing clinicians, 3) pharmacist assesses patient’s needs & manages their drug therapy, 4) pharmacist orders & administers immunizations, and 5) payers cover & reimburse for pharmacists’ patient care services. These policy interventions may be found in state’s pharmacist scope of practice or collaborative practice laws. The assessment focused on outpatient patient care services for heart disease and stroke prevention in outpatient settings with an emphasis on outcomes related to hypertension and cholesterol management.

Results: Using the QuIC Assessment methodology, 143 peer-reviewed articles and grey literature documents were classified into one or more policy interventions and assessed for their potential public health impact and evidence quality. Each of the policy interventions achieved the highest rating for very strong evidence for potential public health impact and high or very high quality of evidence. Outcomes included decreased blood pressure and cholesterol, improved medication adherence, decreased health care costs for patients, and increased access to care for people experiencing health disparities, including racial and ethnic minority and uninsured populations.

Conclusions: We identified evidence-informed policy interventions for pharmacists’ patient care services for heart disease and stroke prevention. Findings will be summarized within this presentation and publicly available resources. This presentation and subsequent resources can inform decisions by policy makers and health system leaders about pharmacist services and policies to enable these services. Pharmacy researchers can consider using similar approaches to assess the best available evidence for state policy interventions that may support pharmacists’ patient care services for other health conditions.