Factors that Promote the Creation of PRISM

US Healthcare spending exceeds $2.7 trillion dollars and makes up 18% of the Gross Domestic Product.  Over 74% of office visits result in, or are a result of, medication therapy issues, but there is no routine provision of comprehensive medication optimization and management services that ensures optimal outcomes.  Medications are a cornerstone of the management of most chronic conditions. For patients with chronic diseases, various factors—such as having multiple medical conditions, seeing several providers, taking numerous medications, and having adverse reactions to drugs—can complicate the appropriate use of medications. Over 1.5 million preventable medication adverse events occur annually, 32% of medication related adverse events lead to hospital admission, and drug interactions are an important issue in medication use at home. Furthermore, only 33–50 percent of patients with chronic conditions adhere completely to the medication regimen prescribed by their health care providers.

In addition, the healthcare system is being pressed to provide access to care for millions of previously uninsured or underinsured patients in a cost-effective manner.  Many of these newly insured patients are also the most vulnerable.  They are medically complex, economically disadvantaged, ethnically diverse, and many possess language barriers.  To date, not enough work has been done to target their medication-related issues and to discover effective ways to engage them in health promotion activities.  While the nation as a whole has seen dramatic reductions in diseases like hypertension, myocardial infarctions, and dementia, the most vulnerable citizens do not share in the benefits.  Such negative clinical outcomes also result in negative economic and humanistic outcomes.  For example, the sickest patients become much more expensive because they put off care and prevention until it is too late, driving up health care costs for the entire community.

UConn’s Investment in Creating PRISM

As a Carnegie-Engaged and land-grant university, UConn has an important public engagement role.  The academic plan recognizes fully the importance of health related public engagement and emphasizes aspirations to be a “…nationally recognized leader in translational research, with special emphasis on underserved populations” and in “…promoting the health and wellness of our citizens, and eliminating the disparities and injustices that plague our society”.  PRISM aligns with two major priorities in the UConn Academic Vision – Interdisciplinary Initiatives and Health and Wellness. 

Consistent with these ideals and their confidence in the School of Pharmacy, the University approved the hiring of additional faculty members to join our current cadre of Pharmacy Practice faculty and provided financial resources to launch our PRISM initiatives.  For over a decade, the Department of Pharmacy Practice has been a major contributor to UConn’s public engagement activities with several faculty being recognized for their major impact to the public good.  The PRISM infrastructure provides additional support to allow the Department of Pharmacy Practice to partner more closely with pharmacists, community pharmacies, community-based organizations, primary care providers, accountable care organizations, and integrated delivery systems, state agencies, and health care transformation policymakers than ever before. 

Nate Poster
S. Gernant