The comparative effectiveness research study will examine the effectiveness and costs of different strategies for providing education, case management, and disease management to reduce cardiovascular disease risk among American Indian and Alaska Native adults with diabetes and/or cardiovascular disease. The strategies involve the provision of services by advanced pharmacy practitioners and other health professionals. CAIANH will provide technical support and training to IHS and Tribal personnel to enhance their capacity to utilize the data infrastructure for similar analyses.
Throughout the IHS service delivery network, education, case management, and disease management is provided by a variety of health care professionals (physicians, nurse practitioners, physician assistants, certified diabetic educators, and other providers such as those certified through the IHS Integrated Diabetes Education Recognition Program), including advanced pharmacy practitioners.
Within IHS, 22% of pharmacists are advanced pharmacy practitioners; they are nationally credentialed by the IHS National Clinical Pharmacy Specialist Program to provide prescriptive primary care in diabetes and a number of other diseases and health conditions. Prescriptive primary care includes the provision of education and disease management and the ability to initiate and modify prescription medications, order laboratory tests to medically monitor patients, and provide other patient care services. These primary care services are delivered under collaborative practice agreements with local physicians.