Implementation of a pharmacist-delivered Medicare counseling service in a rural community health center

2020 ◽  
Vol 60 (4) ◽  
pp. e79-e85
Author(s):  
Adriane N. Irwin ◽  
Elisabeth H.M. Manning
Keyword(s):  
Community Health ◽  
Health Center ◽  
Rural Community ◽  
Community Health Center ◽  
Counseling Service ◽  
Rural Community Health

scholarly journals Weight gain prevention among black women in the rural community health center setting: The Shape Program

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Perry Foley ◽  
Erica Levine ◽  
Sandy Askew ◽  
Elaine Puleo ◽  
Jessica Whiteley ◽  
...  
Keyword(s):  
Weight Gain ◽  
Black Women ◽  
Community Health ◽  
Health Center ◽  
Rural Community ◽  
Community Health Center ◽  
Weight Gain Prevention ◽  
Rural Community Health

scholarly journals Evaluation of Warfarin Use in Patients With Mental Health Conditions in a Rural Community Health Center System

2020 ◽  
pp. 875512252096022
Author(s):  
Laura Abell ◽  
Adriane N. Irwin
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Health Center ◽  
Rural Community ◽  
Community Health Center ◽  
Interquartile Range ◽  
Health Conditions ◽  
Target Range ◽  
Mental Health Conditions ◽  
Rural Community Health

Background: Mental health conditions (MHCs) may affect a patient’s ability to comply with requirements necessary for safe warfarin use. Objective: To describe warfarin control, defined as time in therapeutic range (TTR), for patients with and without MHCs receiving care through a pharmacist-driven anticoagulation service within a rural community health center system. Methods: Retrospective cohort study of patients on warfarin between January 1, 2014, and December 31, 2017. The primary study endpoint was TTR. Secondary endpoints were the number of international normalized ratios (INRs) per 30 days, percentage of INRs within, above, and below target range, and warfarin-related adverse events. Results: A total of 79 patients were included—37 with and 42 without MHCs. Patients were mostly male (n = 47; 59.5%) and prescribed warfarin for atrial fibrillation (n = 45; 57.0%). There were no differences in overall TTR between those with (59.6%; interquartile range = 41.8-73.4) versus without (63.4%; interquartile range = 46.7-73.6) MHCs ( P = .542). Secondary outcomes showed no differences in the frequency or percentage of INRs in, above, or below target range (all P > .05). However, there were about twice as many hemorrhagic complications in the group with MHCs (27% vs 11.9%; P = .149). Conclusion: Patients with MHCs experienced no difference in overall TTR as compared to patients without MHCs. However, there was a non-statistically significant reduction in TTR, which would be consistent with limited existing data and demonstrates possible reproducibility to a rural, underserved patient population. Future research is needed to validate these outcomes.

scholarly journals Delivery of an Ebola Virus-Positive Stillborn Infant in a Rural Community Health Center, Sierra Leone, 2015

2016 ◽  
Vol 94 (2) ◽  
pp. 417-419 ◽  
Author(s):  
Hilary Bower ◽  
Aaron Brault ◽  
Eunice Chege ◽  
Gbessay Saffa ◽  
Dean Seneca ◽  
...  
Keyword(s):  
Community Health ◽  
Health Center ◽  
Sierra Leone ◽  
Rural Community ◽  
Ebola Virus ◽  
Community Health Center ◽  
Rural Community Health ◽  
Stillborn Infant

Medical–Dental Integration in a Rural Community Health Center: A Qualitative Program Evaluation

2021 ◽  
pp. 152483992110028
Author(s):  
Catherine Pawloski ◽  
Juliana Hilgert ◽  
Kirsten Senturia ◽  
Stephen Davis ◽  
Mark Koday ◽  
...  
Keyword(s):  
Community Health ◽  
Health Center ◽  
Quality Care ◽  
Community Health Center ◽  
Implementation Strategies ◽  
Patient Identification ◽  
Integration Strategy ◽  
Rural Community Health ◽  
Eastern Washington ◽  
Dental Providers

Background A community health center (CHC) implemented a medical–dental integration (MDI) program where children were seen at a pediatric medical clinic or women, infants, and children program location by medical and dental providers in the same visit. Our study aims were to elicit the perspectives and experiences of providers and administrators involved in the MDI program to assess the acceptability, feasibility, and success of a CHC integration strategy in Eastern Washington. Methods This is a qualitative study where we conducted semistructured interviews over the phone over a period of 2 months with 12 medical and dental providers and clinical administrators who were involved with the MDI program. Questions addressed perspectives on workflow, patient identification and engagement, leadership support, and barriers and facilitators of the initiative. Qualitative data were analyzed, and emergent themes were identified. Results The emergent themes included (a) the MDI program is feasible and acceptable albeit with key considerations regarding the setting, including charting and service integration, progressive leadership and effective communication, and appropriate providers; (b) implementation included structural, systemic, and individual behavior barriers, (c) the program is seen as a benefit to the clinic and patients and a success to date as a way to increase access to quality care. Conclusions Findings from this study helped identify facilitators, such as cultural relevancy and progressive office systems, as well as barriers, such as reimbursement, associated with integrating medical and dental care in a rural CHC setting, is acceptable by providers, and can inform future studies and implementation strategies for others wishing to integrate these services.

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