PRISM Diabetes, Metabolic Syndromes, Cardiac Diseases, and Respiratory Conditions

In collaboration with Brownstone Clinic/Hartford Hospital, Burgdorf Primary Care Clinic, and UConn Health/General Medicine Associates, we have a unique strength in the primary care management of major chronic conditions including, diabetes, metabolic syndrome, and cardiac diseases, and respiratory conditions including smoking cessation. With clinical pharmacy faculty practicing at each of the aforementioned sites, we are dedicated to improving the health of the people of Connecticut, with special expertise in caring for those with complex pharmacotherapeutic and psychosocial needs such as urban and underserved populations. Additionally, UConn School of Pharmacy’s primary care faculty have extensive experience with  training the next generation of not only pharmacists, but also future primary care physicians and nurse practitioners in the optimal prescribing and monitoring of the many medication drug classes prescribed in outpatient settings.

Our pharmacy faculty have a unique niche, working directly with primacy care providers to develop, modify, and monitor patient-specific care plans. Additionally, they meet with one-on-one with patients to discuss their medications, medical conditions, goals of therapy, and nonpharmacological management, including lifestyle interventions. In this longitudinal setting, our faculty build relationships with their patients, providing their therapeutic expertise, along with support and encouragement, throughout the patients’ medical care journey. The continued presence of pharmacists in these settings enhances the patient care process and health of the patients.

In addition to providing clinical services, our faculty have developed scholarly recognition in the area of pharmacists in primary care and in the management of major chronic medical conditions. In a new major initiative funded by the State of Connecticut Department of Public Health from 2017 to 2019, the impact of community pharmacists on reducing smoking rates in patients experiencing tobacco-related disparities through an integrated approach which links the Quitline, provider services, and approved pharmacotherapies. Pharmacists in the community can create a community-clinical linkage to increase screening, promote cessation, and offer access to effective services to those who want to quit.

Publications in this area include:

Glasser I, Wang F, Reardon J, Vergara C.D., Salvietti R, Acevedo M, Santana B, Fortunato G. Improving COPD Care in a Medically Underserved Primary Care Clinic: A Qualitative Study of Patient Perspectives. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2016;13(5):616-21

Trivedi R, Salvo MC. Utilization and safety of common over the counter dietary/nutritional supplements, herbal agents and homeopathic compounds for disease prevention. Med Clin North Am. 2016;100(5):1089-99.

Kusher A, Salvo M. Impact of Community Pharmacist Intervention on Self-Care and Behavior Change of Patients with Diabetes and/or Hypertension. SelfCare. 2016;7(1):1-9.

Colby JA, Wang F, Chhabra J, Pérez-Escamilla R. Predictors of medication adherence in an urban Latino community with healthcare disparities. J Immigr Minor Health. 2012 14(4):589-95 (IF=1.16) DOI: 10.1007/s10903-011-9545-7.

Salvo MC, Brooks A. Outcome of glycemic control and achievement of preventative care measures in indigent diabetes patients within a pharmacist-managed insulin titration program vs. standard of care. The Annals of Pharmacotherapy. 2012:46(1):29-34.

Smith MA, Dang DK, Lee J. E-prescribing: clinical implications with diabetes patients. J Diabetes Sci Technol 2009;3(5):1215-1218.

Salvo MC, Nigro SC, Ward D. Pharmacist-Generated Electronic Consults to Improve Hypertension Management in a Multisite Health Centre: Pilot Study. Inform Prim Care. 2013:20(3):181-184.

Ponte CD, Dang DK. Drug-induced diabetes. In: Holt R, ed. Textbook of Diabetes, 5th Edition. In press.

Wang T, Wang F, Zhou J, Tang H, Giovenale S. Adverse Effects of Incretin–based Therapies on Major Cardiovascular and Arrhythmia Events: Meta-analysis of Randomized Trials. Diabetes Metab Res Rev. 2016; 32:843–857. Published online 6 May 2016 in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/dmrr.2804.

https://doi.org/10.2147/DMSO.S87873>Wang F, Zassman S, Goldberg PA. rDNA insulin glargine U300-a critical appraisal. Diabetes Metab Syndr Obes. 2016; 9:425-441. Published online December 2, 2016.

Sundeep Bhat, Wang Fei. Drug Information Update: Hartford Hospital. Health Literacy and Implications for Patient Care. Conn Med. 2016;80(7):427- 432

Salvo MC, Brooks A, Thacker S. Patient considerations in the management of type 2 diabetes – critical appraisal of dapagliflozin. Patient Prefer Adherence. 2014;8:493–502.

Dang DK. Taking medications. In: Mensing C, ed. The Art and Science of Diabetes Self-Management Education: a Desk Reference for Healthcare Professionals, 3rd Edition. Chicago: American Association of Diabetes Educators, 2014:175-196.

Salvo MC, White CM. Reconciling Multiple Hypertension Guidelines to Promote Effective Clinical Practice. The Annals of Pharmacotherapy. 2014;48(9):1242-1248.

Kalantaridou SN, Dang DK, Calis KA. Hormone therapy in women. In: DiPiro JT, Talbert R, Yee G, Matzke G, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach, 9th Edition. New York: McGrawHill, 2014:1315-1336.

Tomky D, Marjorie C, Dang DK, Maryniuk M, Peyrot M, Mensing C, Fitzner K. American Association of Diabetes Education position statement on AADE 7™ self-care behaviors. Diabetes Educ 2008;34:445-9.

McGriff-Lee NJ, Csako G, Chen JT, Dang DK, Rosenfeld KG, Cannon RO, Macklin LR, Wesley RA for the Anticoagulation Working Group. Search for predictors of nontherapeutic INR results with warfarin therapy. Ann Pharmacother 2005;39:1996-2002.

Wang, T., Wang, F., Gou, Z., Tang, H., Li, C., Shi, L. and Zhai, S. Using real-world data to evaluate the association of incretin-based therapies with risk of acute pancreatitis: a meta-analysis of 1 324 515 patients from observational studies. Diabetes Obes Metab. 2015; 17(1): 32-41; DOI: 10.1111/dom.12386. (IF=6.36)

Wang T, Gou Z, Wang F, Ma M, Zhai S. Comparison of GLP-1 Analogues versus Sitagliptin in the Management of Type 2 Diabetes: Systematic Review and Meta-Analysis of Head-to-Head Studies. PLoS One. 2014. 4;9(8):e103798. DOI: 10.1371/journal.pone.0103798. PMID: 25089625

Wang F, Corman A, Sounthonevat C, Baldino J. MTM considerations in osteoporosis care. Current issues for prevention and treatment. Drug Topics. 2013;157(10):36-48

Wang F., Surh J., Kaur M. Insulin degludec as an ultra-long-acting basal insulin once a day: a systematic review. Diabetes Metab Syndr Obes. 2012; 5:191-204. DOI:10.2147/DMSO.S21979

Vergara C, Martin AM, Wang F, Horowitz S. Awareness about Factors that Affect the Management of Hypertension in Puerto Rican Patients. Conn Med. 2004; 68(5):269-76. (PMID: 15171262)

Coleman CI, Reddy P, Laster-Bradley NM, Dorval S, Munagala B, White CM. Effect of practitioner education on adherence to asthma treatment guidelines. Ann Pharmacother. 2003;37(7-8):956-61.

Coleman CI, Reddy P, Laster-Bradley NM, Dorval S, Munagala B, White CM. Prescriber and pharmacist responses to intervention letters for Connecticut Medicaid beneficiaries with asthma. Am J Health Syst Pharm. 2003;60(11):1142-4.

White CM, Chow MSS. Cost impact and clinical benefits of focused rounding in the cardiovascular intensive care unit
Hospital Pharmacy 1988;33(4):419-423

Quercia RA, Abrahams R, White CM, et al. Cost avoidance and clinical benefits derived from a pharmacy-managed anemia program. Hospital Pharmacy 2001;36(2): 169-175.

White CM. Ensuring that patients receive full cardiac pharmacotherapy services: a pharmacist’s call to arms. Ann Pharmacother. 2006;40(12):2248-50.

White CM. Ann Pharmacother. Pharmacists need recognition as providers to enhance patient care. 2014 Feb;48(2):268-73.

Funded grant projects in this area include:

Creating community-clinical linkages to reduce disparities in smoking rates in vulnerable populations. Sponsor: State of CT Department of Public Health Tobacco Control Program (DPH RFP#2016-0905: Best Practices in Tobacco Control, for Component 3: Cessation Interventions).  $281,068 PI: Fei Wang.

Predictors of Poor Medication Adherence Among Urban Latinos: A Cross-Sectional Analysis of Patients Enrolled in the Diabetes Among Latinos Best Practices (DIALBEST) Trial. Sponsor: ASHP Research and Education Foundation, Pharmacy Resident Practice-Based Research. $5000 Senior Investigator: Fei Wang.

Medical Office Survey on Patient Safety Culture. Sponsor: Hartford Hospital Medical Staff Patient Safety and Quality Initiative Grant. $12,774. PI: Fei Wang