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Diabetes Care in Community Health Centers: A Focus on Health Resources and Services Administration-Funded Clinical Pharmacy Demonstration Projects

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	Introduction

 
Millions of Americans have limited access to health care and are ethnically diverse and medically underserved. Many of these patients are seen in community health centers (CHCs). These centers are federally supported clinics that provide primary care services for > 11 million underserved patients.¹ CHCs were established in 1965 under the Public Health Services Act, through a federal grant program. CHCs serve patients who are uninsured, underinsured, or have a very low income. Many of these patients are at great risk for safety because of cultural or language barriers.

Starting in 2000, the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services awarded clinical pharmacy demonstration grants to 18 CHC networks. The purpose of these grants was to demonstrate that access to medications and comprehensive pharmacy services results in an improvement in the health status of patients by either starting pharmacies to provide affordable medications through 340B Drug Pricing Programs² or expanding medication assistance programs (MAPs) by pharmaceutical manufacturers. Another goal was to determine the impact of pharmacists on diabetes and its comorbidities in these settings. In many cases, CHC patients were provided access to pharmacist care for the first time. These networks were composed of HRSA-funded health centers, a college of pharmacy, and sometimes other organizations.

Mathematica Policy Research, provided the overall evaluation of these grants and prepared a report to the HRSA.³ Mathematica highlighted five of the clinical pharmacy demonstration projects (CPDPs) in their report. Each CHC project was unique, but all provided certain components of disease management, expanded patient access to medications, medication formulary activities, and training of pharmacy students or residents. The highlighted projects had at least three characteristics in common: positive diabetes disease management clinical data, a large number of patients given pharmacist-provided care, and good retention rates (majority of . . . [Full Text of this Article]

	El Rio Project

 

	Siouxland Project

 

	Salt Lake City Project

 

	Bond Project

 

	Trenton Project

 

	Case Study

 

	Diabetes assessment

 

	Interventions and diabetes care plan

 

	Follow-up

 

	Conclusions

 

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